HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: yT` �� Permit Number: \�\d `i -d 53 q
SCANNED RECEIVED
:...:,, BY
"s St. Lucie County APR 2 2 2019
Building Permit Applica igrtude County, Permitting
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: Re,_ RC19P _ -P� }q \
Address: 606 Fes; "%I AA tf P1eree..
Property Tax ID#: S4oA-6o5-Qo93- oD0-!K Lot No.
Site Plan Name:
Project Name:
TewJ eig PK,S-A1 Mot T%&5Ra.(1 $Dlb Self cLNJ 5x/ Lr n+P wl2 W.
Additional work to be performed under this permit— check all that apply:
Block No.
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _Sprinklers _ Generator- ✓Roof Pitch
Total Sq. Ft of Construction: F>300
Cost of Construction: $ 14D00
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
Name'lbJr,in'.... trv�J 110• &5e Ak rAO :201
Address: 696 E �av%: VJ
City: 64- P 'rK State: _
Zip Code: 3Q1 4.9- Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: pdir,&. F, i5M.00w.w/t '
Company: M'r:se foXY,5 LL .-
Address: R181 M ."i" ,r��, `�«ich id
wM
City: pjfF Si %WState:
Zip Code: 57ir1SX Fax:
Phone No
E-Mail .QDfiaw 905/6 aAaw4 1 ® a/900k• cow
State or County License6[C 15311go
f value of construction is S2500 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 ON -1 ION LIE LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
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 R IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTep ON THE JOB SITE BEFORE THE•FIRST INSPECTION- IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WIT OUR LENDER OR ANATTORNEY BEFORE RECORDINC/YOUR NOTICE OF COMMENCEMENT-".'
as Agent for Owner
STATE OF FLORIDA
COUNTY
OF Sk
The forgoing instrument was acknowledged before me
this a day of Ok R t' s N 20 1 by
Ykd��av� �os�•4d.�,dv�-�
Name of person making statement.
Personally Known OR Produced Identification
Type of (dent f�ation
Produced L ',_,, y—
(Signature of Notary P016lic-
Commission Noda�.0
REVIEWS FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
STATE OF FLORIDA
COUNTY OF l Oc°
The forgoing instrument was acknowledged before me
this'��layofa e f �\ 20�'% by
`A X L\ 0.'^ t4 J 3 4- -- J v. +0'
Name of person making statement
Personally Known OR Produced Identification
Type of Id
entification
Produced j
(Signature of Notary P lic- State of florid ,
MAMA IE GNENS d
C mission No. MIssI02z07 t
I =;: EXPIRES: December 16,2020 `
hers o:;- Banded tiw Notary Public UndenvnteF+; I
RENING VIEW W SUPERVISOR REVIEWI REV EW VEGETATIEVI WON I SEATURTREV EWLE RE MANGROVE
Rev 2/7/19