HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INF �MyUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I n jr� �j�
Date: y g % Permit Number: u `l V U 11Y� �4�1
Ric SCABNNED
qpqq ° t. Lucie CouT
-- — _- Building Permit Appl t10�122#19
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Planning and Development Services sp i,700
Building and Code Regulation Division 4Nc1e Cme
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE: Pe_Ppo. f Sh inq/e - w/ al
Address:
PropertyTaxlD#: uil9 — 6GI — 009&—C17O—/ _ _ Lot No,
Site Plan Name: :Sa /.�iees/dm(r v Block No.
Project Name: rc I )
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters —Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator /'Roof / I l Pitch
Total Sq. Ft of Construction: //7 Sg2l l�s Sq. Ft. of First Floor: IV T
Cost of Construction: $ Utilities: -Sewer _Septic'
Building Height:
01�11NERLESSE x.41
Name Rawl f SQ I 9a O
ONT({gCTOR
Name: a e
Address: ZJ�_ 3 ���{l�
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Company: 4eaq 1S
City: Ffik State: F1-
Zip Code: :3 ygC17 Fax: -772 97Z 05133
Phone No. Z 3 d
Address:?;,�ZQJIF d.1'bminl5t. 7errc e
city:,c? UGt1- state: F-L
Zip Code: q L Fax:-7Z 97z803
phone No 7-7217-& gQ30
E-Mail:SGtI"IZ/(A-fOW /?TOi�6j(S�&K
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail SCU241 r6t925f Q%/ L� -< }/S WS
State or County License GCMG 1 330-7 q,9
it 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.
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SUPPLEMENTAL CONSTRUCTION C1EN LAW INFORMATION
•C.. •c^Xc R _£ 4�c '�•'c n.. t. . r _'f[.
DESIGNER/ENGINEER: �Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name: T
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ 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 Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in convict with any applicable Home Owners Association bylaws
rules, 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 SPE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF CO CEMENT."
f Owner/ Lessee nt or gent for Owner
S7ATE
Signatur Contractor ense
S FLORID
COUNTY OFMamn
ATE OF FLOR
COUNTY OFMamn
The forgoingfoiggoing instr ments acknowledge before me
this day of ri 1 .20 by
The for ing instru ent was acknowledged efore me
this day of20 ��by
t1
Name of person making statement.
Name of person making statement.
Personally Known _�( OR Produced Identification
Type of Identification
Produced
Personally Known / ` OR Produced Identification
Type of Identification
Produced
(Signature of Not y P blic- Stat of Florida )
(Signature of Not u i -St t f Florida)
Commission No. GAS �oa3d (Seal)
Commission No.G'G (Seal)
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
""•• THERESA JAFFE
1�Ye
Notary Public- State of Florida :••••••. T ERESA JAFFE
;'i�'Y , H
Commission!! GG 2G2301 io Notary Public -Stale of Florida
tee, . Ex Tres Apr 1, 2022
is ; Commission N GG 202301
-- Bonded [nraugn �.o..-••---�
Banded through National Notary Assn.