HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number: I
_ BY
•iS• '-'� = - l St. Lucie County RECEWED
• Building Permit Application APR 17 1019
_ Planning and Development Services __ _ permitting Department
Building and Code Regulation Division St. Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION: _
Address:'
Um _tyA4X
Property Tax lDoD36-ooe-g Lot No. may
° Site Plan Name: Block No. /✓/%1
/✓T
Project Name: t -bd+1 NSA -
DETAILED DESCRIPTION OF WORK:
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I CONSTRUCTION INFORMATION: I
Addition I work to be performed under this permit- check all that apply:
�Nanic gh•JJCAL) — — —
echanical Gas Tank Gas Piping Shutters Windows/Doors
_ Electric _PI bi Sprink ers _ Generator _ Roof Pitch
°Total Sq. Ft of Constructti J1 D _ -Nc� q/C Sq. Ft: of Firsor: NfA
a Cost of Construction: $ f O & -N A/C Utilities: Sewer ) Septic Building Height:_
OWNER/LESSEE:
CONTRACTOR:_
Name
Name:
Address: A79a /J-/ii
Company: !, rJ CDN
odl�
City: State:
ZipCode:!349/96 Fax:
Phone No:_
E-Mail, JZW1A6/e ni7y.n�7`
Address, S
City:
Zip Code: 13N1S Fax:
Phone No
State:;.
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail W117 0 L n Lnsi7-uef
ao<• Coin
State or County License ram,(_
If value of construction is Szsou or more, a newnucv rvovice or �.gmmeuce.nc,.. W .may.... �...
If value of HVAC is $7,500 or more, a RECORDED Notice of commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGN��ErrR/��ENGINEER: Not/A plicable
MORTGAGE COMPANY: _ Not Applicable
_
Name:16 �'` �� Ar,6 �ccb ( 9r, ������
Name: RAM of COMMERCE -
Address: 101 W. MArd lf.
Address: r � to t_t- J f.
City: CH de, E State: KAN1A�
City: �L o, f State: FL .
Zip: ?449V'1 Phone 99a2 ��3-3J4�
Zip: 669do Phone: aa- I OD
-FEE-SIMPLE TITLE HOLDER:A__ Not Applicable
BONDING COMPANY: _ Not Applicable.
Name: MApK h/124cMch
Name:
Address:
Address: /d77o NW 1r1AR1NAR cT
City: t cr
City:
zip: 39990 Pho e:L ! - V- o
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 Counttflyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
restrict or such
wh
structuin re. Please consult withpyoiur Home Owners Associationlandrreview your deed or any restrictionsvenants
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 MST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INT TO OBT N FlNA ING, CONSULT
.
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YO R NOTI 0 E C
Signature of Owner/ essee/Co actor as Age ,or Owner Sig to f ontr ctrfr/License Holder
STATE OF FLORIDA TATE OF FLORID''_
COUNTY OF '� L1G o < COUNTY OF f <;
The for Ding instrument was acknowledged be rgrtmm A The rgo,�+�qqg instrr m—en�t was acknowle a g(k�rie.
. 20� b a H d ,`o_ this clay of ( 2�b�Y o
this day o'f•
`�
Name of person making statement. s ; .E a s` Name of erson making statement
>9
o o ci m
OR Produced Identi cat�n" T ` Personally Known 'V OR Produce I'de[ytilGjdn
Personally Known
Type of Identification +. Type of Identification w T m
Produced.`eq;= Pr duced - ?wig
T
O�
( ignature of t Public- State doff, Florida )'__ _ Al ature-of Notary ublic- stattee of Florida) .
Commission No* MA (Seal) C i ission No. ��.` 1 (Seal)
REVIEWS
FRONT
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SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
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RECEIVED
DATE
COMPLETED
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