HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COM'&LcTED FOR APPLICATION TO BE ACCEPTEI
Date: SCANNEDPermit Number: 1 �u�_/
BY a�
St. Lucie County
fill Building Permit Application 010 6 it's
arunent
Planning and Development Services Pe"'ftu' oeP
5 , wcie Coun
-Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: 19-p
PROPOSED IMPROVEMENT LOCATION:
Address: nU7)!t
Property Tax ID #: I I✓'6 g — ' Lot No.
Site Plan Name: _ Block No.7
Project Name: +or r U n C
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers —Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ I ",2D Utilities: —Sewer —Septic
- Windows/Doors
V Roof L±/1.a Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name + n
Name: S
Address: C�jq(ba Y>V'e--
Company: �(aIC
rghi j 7(-
onq-
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City: }- R'\-Pr-C.-2_ State
Zip Coder I Fax:
Phone No. %7Q—[7��i���3�
E-Mail:
Address:to- LLSk?I
l?_Tml&
City: --F7 P� IrCeP
Zip Code:31-115
Phone No -17� - µ&6-Tl00
State:
Fax:77QR(.OLi- O3ba+
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail T�Nr{C Ml ON
I roe-- t3+
State or County LicensecN,et
059 yy
it value of construction is.2500 or more, a RECORDED Notice of Commencement is regluif4d.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTALCONSTRU NLIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
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 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 HE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH Y NDER OR AN ATTORNEY BEFORE RECORDING YOUR T40411E OF COMMENCEMENT:'
Sign re of ner/ ssee/Contractor as Agent for Owner
SignrEof C tracto tcense Holder
ST TE OF FIL ID n
COUNTY Ad 1 an e V'e(L-
STAF FLORIDA
a% I
OF
COUNTY OF�Q 1 CA_ii
The for ing instru t as acknowledge before me
this�dayof//��r� I(lI 1^,'.�20TT by
The for oing Ins tru entwas acknowledged before me
this7dayof� by
TC�}'l�YI�CL
� .20B
� Yl I Ne IK PCcy—
Na a of person making atement.
Name of person making statement.
Known Personally OR Produced Identification
Personally Known — _V OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced p �p �/� q �, '�
Q,QY1{o4-Cis UY W�IPIl:'�—/
(Signature of Nota P blic- Sta a of FI 'oa<,)c
KELLY L. MON
nature o tary Public- tate o F rida )
"ems KELLY L MONEYHAN
Commission No. * * MY COMMISSION#FF903559
EXPIRES: July
, a°: ' ` COMMIS IFF90
6,%I9mission No. ,
July 26, 2D1
XPIRES:
BondedThN B el N
Services '%s�_ ye:° Bonded TNu BAletNolarySe
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev. 2/7/ 19