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Home My WebLink AboutBUILDING PERMIT APPLICATIONJ-� All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 4 Date: g 1 Permit Number: RECEIVED JIJ�4&—_ _ (• APR 0 5 2019 Building Permit Applic `3p[dcie County, Permittin Planning and Development Services Building and Code Regulation Division SCAN 2300 Virginia Avenue, Fort Pierce FL 34982 / BY Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential St. Lucie PERMIT TYPE: S AdMsJ S hl fk)R PAA14 ( PA 11 Ct_-) PropertyTaxlD#: '4/ —s01- ADDS- goo-6 Lot No. A?1L1,F 6Rd✓TS Site Plan Name: Block No. Project Name: Additjonal work to beperTasTank ed underthis p�rmit — check all that apply: Mechanical Gas Piping _Shutters Windows/Doors Electric lumbbinng _Sprinklers _Generator l ryRoof 2 :� Pitch Total Sq. Ft of Construction: 47 6U Sq. Ft. of First Flo r: Ale,7 (jS g,,ee J Cost of Construction: Utilities: _ Sewer _ Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name ew4ii A Coi21CLQF Name:' 6 / Me Addresrs:,t'OS'��HCfi� t)�. /7 �1%fS ., y� Company: City YTID��2G�� ^T, - State:_ Zip Code 3� faz c n Phone No.%��"a/ ��,.// Addres3`71 City:(14,itre " it l .:. : ,.':' State:f tt zip CodeFax: Phone N4x•7,• • r " 47"- E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) r E-MailZQf4G J/k D/ 07 B 6 MAi G 1e&V- State or County License6,99,016 � fro If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONS ION LIEN LAW INFORMATIO DESIGNER ENGINfER: Name: Kd r040"t _ Not Applicable MORTGAGE COMPANY: Name: OfA 9 659Te _ Not Applicable Address: I;a p Av< Address: >r 0 S koA City: Zip: Phone `7'21--0o: State: FL `1Kc14 City: Pr 'FIF0Z Zip: �V•95A Phone: State: [� FEE SIMPLE TITLE HOLDER: Name: _ Not Applicable BONDING COMPANY: Name: _Not Applicable Address: Address: City: City: Zip: Phone: Zip: Phone: 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH yOUR'LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OECOMMENCEMENT." Si t re of Owner/ essee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORn. COUNTY COUNTY OF 1AI—b i L OF The forgol.ng instru ent was acknowledged before me this day of O20A!T by The forgoing instrument was acknowledged before me this L OLday of 2019 by p pq� �� ({n o j! lltix ``L7// 1\ I �. QZOb��r E) . 401,_ � Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Prgrjucej degfication Type of Identification Produced ��X= Type of Identification Produced a+'p��^� (S fure of N ary Public- State of Florida ) (Signature of No Public- State of Florida) Commission No Cer�•��t�uUOt NOiAFIYrPUBLIC Commission No. ;'i�°O�'-. CHER{'�RfldwE Notary Public - Stateof Florida 5- °7 Commission # GG 260038F_Xpl(BB STATEOFFLORIDA Catrara'JGG137180 */02E5f252020 "`•--•••'" y Comm. Expires N v 30, 2022 REVIEWS ISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 2/7/19