HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE CCn,irLETED FOR APPLICATION TO BE ACCEPT G-o
Date'IA
' A' k �1L,' :q d"S Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
C 61 Q 1-7 RECETVED
Building Permit Application APR 12 2019
ST. Lucie County, Permitting
Commercial Residential
PERMIT APPLICATION FOR: db U 0 SC
PROPQSED„I,NPROUEMENT LOCATION _., �, ! 4 _�' h`' ` ` r:''" t, .'; � ' , =� '• BY'�; ,', �,: w
Address: C v4✓ I Ors m,q mr j c /� Cle OUf1�
Legal Description: /910 i!s Lie
Property Tax ID #: _ 4%I 2 6 •/3 "
0y
Site Plan Name: f C-6.��-�
Project Name: '' F C.-
Setbacks Front Back:
Right Side: Left Side:
a
,c'
•mit—r ork n t vt ann r,
_Mechanical _ Gas Tank _ Gas Piping
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: V
Cost of Construction: $ 2 9
_ Shutters
—Generator
Sq. Ft. of First Floor:
Lot No.
Block No.
r�
Windows/Doors
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNERJLESSEE
'_ y{ e , j
.CONTRACTOR
Name
Name: A -ca -e
Gar iJ
Address: u15a.y NW
Company: Z�r-eG sg7-xl
City: `� �- State: L- ,
Zip Code:3 Fax:
Phone No. ]-la - 519-1949
Address:
City: v N r r•e�_:
Zip Code: ff p
Phone No
State:
Fax:
E-Mail: rner�xtse� 1-il a7�m Y�.1. com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail
State or County License
n value or construction is 250D or more, a RECORDED Notice of Commencement is required.
Not
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
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 4,d 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 use 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 OF COMMENCEMENT."
511
as Agent for Owner
STATE OF,FLORIDA STATE OF FLORIDA 1
COUNTYOF S Ci ,!' /GI Pi COUNTY OF !n LIG/ (Zi
The forgoing instrument was acknowledged before me
this day of It 2014 by
Name of person making statement'Personally Known v OR,Produced-Identification
Type of Identification
Produced ,
F= Notary Public -State of Florida
Commission M GG 1p�7
Commission :'?Piresapr 13, 2pssn1)1
Bonded through National Notary A.
REVIEWS FRONT
l COUNTER
DATE
RECEIVED
ZONING' SUPERVISOR
REVIEW I R VIEW
The forgoing instrument was acknowledged before me
this _ea day of W 20_q by
Name of person making statement.
Personally Known` OR Produced Identification
Type of Identification
Produced
( r.
( igna reW`1`1*a!yV4Lb1r& State of Florida )
CommissionNo._ EIIENDA1CMET o(FNOrpoA
Diary Public-S Ara
4 � Commission 1GG 10/712
REVIEW VREVIEW I REVIEW I REVIEW
All APPLICABLE INFO MUST BE COMPL.%�J FOR APPLICATION TO BE ACCEPTED
Date: OtF'/ah Permit Number:.
Building and Code Re lotion Division
2300 Virginia Avenue, F Pierce FL 34982
Phone: (772) 462-1553 x:(772)462-1578
PERMITTYPE:
PropertyTaxlD#: 203— 2
Site Plan Name: i®
Pr.
on4r
T T Co
I NE
MR.A.MA
W
Additional work to be performed under this permit check all that
V echanical G s/Tank
IITotal Sq. Ft of Construct n: T/ / L
Cost of Construction: A Sm U
I I/
kdt No.
Block No.
-Windows/Doors
Roof ' Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic BuildingHeight.
oMNERT1 __
CONTRACTOR:
Na e&l e
Name:
Ad dre ne rrac
Company:
City v LU1,CRE �'� ' "�" St tei
Zip �4�}�ley. :•Fair `
Phone .•, ,
Addres :
City..
Zip ode:r�
E-Mail
°-1009
E M
Fil n fee simple Title Holder on next page (if different
om the Owner listed above)
State or County License�/�!_ I��/
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.