HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE CONY JED FOR APPLICATION TO BE ACCEPTEI,
Date: 1 Imo' Permit Number: I
SCANNED
BYMi RECEIVED
St. Lucie Count
Building, Permit Applicatio MAR 2 6 2019
Planning and Development Services
Building and Code Regulation Division 5T. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Awnn.� ,ram z-zot,rr—
�vEza_od q MDL�Nom�o c �oa�cr�
Address: I l 1 M\ u n Vic_\ C 1-t-1 F'7 = P (FrL = FL_ 3H9t-,S
Legal Description: 3 -:&S 39 l`1 W 114 1,FS5 Av ot.1 MArlrxt u N \-rS fL •AND ANn 1�CSC U
6\S FT 1.-4�, S oF- Aa Q0 M4;NrJt�CL -QN 1't 2 AN L'E-ss
Property Tax ID #: D303 - a\ \- ooaS - oc-�cp - S Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:.
M t7 171>\L,C= L-k, \e•?—
Additional work to be performed unclerthis permit-c ec all tat apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction;$ 71-1'f �. �S Utilities: _Sewer _Septic Building Height:
Name
Name: 3'0E}r-A . MUcLs-A-)
Address: \01kV 1-4J
Company:, AV\s ANC, '
City: F-1-- P r FsccF State: aL
Address: 91-1 \ 5 W
City: 90rr P WrwJ \zEgcyV State: r-LL
Zip Code: Ii-knyS Fax:
Phone No. _L\HQr g3Sf.
Zip Code: 2,,:NL7� Fax:`isti •7$a -cxj ;S
E-Mail: r11 q
Phone No goo (6G,?
Fill in fee simple Title Holder on next page (if different
E-Mail Af^5 ep FLA • corms
State or County LicenseCE_G_b $`7
from the Owner listed above)
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
Name: '24'4m_s
Address: 330o
City: Q Fi',cN State:
Zip: 33oyw\ Phone 9SL\ q56 2�03
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Address:_ Nl w 3t_-,r-Av;
City: PonnPA,4To 6 £A la t=L�-
Zip: 3 ocQ^ Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Address:
Zip: Phone:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.,
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with len or an attorney before
commencing work or recordingMDur-Noticeof Commencement.
ture o Owner _ ent a' "`• n dcfor
Ss�ne _ _ tact-o' ti errse tta derr
STATE OF FLORIDA
STATE OF FLORI A
COUNTYOF S3cCor�A2�
COUNTY �R. c,-WHCLE�
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this�, dayof Alc'�/320 1n by
this_& dayof yyn,a4rtG\4 .20j!Ei_ by
soli-�v 'l=, MJCL�Lf��/
SoFl r�1 � MJrLrLl3 �/
(Name of person acknowledging)
(Name of person acknowledging)
(Signature of Notary Public -State of Florida)
(Signature of Notary Public- State of Florida )
Personally Known �—OR Produced Identification
Personally Known K OR Produced Identification
Type of Identification �" °_�
T e of Identification F�� Fy
yP �` ALASIONIFR
Produced V f - MYCOMI�ION9FF195499
Produced MY COMMISSION a FF 195499
EXPIRES: May 5, 2019
COmmission NOotr__Tvr_� 19 y--\ "E0TfL Sefflpd thru Bodpi Notary Senkes
P EXPIRES: May 5, 2019
Commission No.F11— 1B015ftJ1d2elNofary Services
i
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DATE
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DATE
COMPLETED
Rev. 7/2014