HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI-111111111111
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5.1a bg Permit Number:
SCANNED
C ' _ BY
St. Lucie County RECEIVED
-� Building Permit Application
Planning and DevelopmentServices MAY 0 7 2019
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 Permitting
Lucie County
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential c
PERMITTYPE: R2aooF
PROPOSED IMPROVEMENT LOCATION:
Address: �unrr92, '�51vd
Property Tax ID #: dLi a$ - (001 - 009S - DOD- S Lot No. 35
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
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 III?- Pitch
Total Sq. Ft of Construction: 11000
Cost of Construction: $ la i Soo. o0
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Karl A Schurk
Name: Urr,l Mcdonalcl
Address:-aao$
Company:$mikynct&naaicrrA,-,et,,,
City: Fof+ el"ce State:
Zip Code: 3_4q$a Fax:
Phone Nkga&i 4b{- aoob
Address:103$0C00dlo4c�rh rOr tIZ32
City: Port CF Lun4 State:r-L
Zip Code: 3498'I Fax:911- 1510-cool
Phone No lI-•t0'1-3535
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail LmcgotJALZ@Souihcnit aMractin� ow
State or County License CCC 13 '�000,2
.. -a ue a cars ru ion 1S 525uu or more, a newxuru Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
Ad9k
SUPPLEMENTAL CONSTRUCTION LIEN 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 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
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
1WITH
Vt I- M Aw
Sign ure of Owner/ Lessee/Contractor as Agent for Owner
SignattWe of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF_ S{ LX1Q
STATE OF FLORIDA
COUNTY OF Sk Lucne,
The forgoing instrument was acknowledged before me
this a day of ML1k 20_)g by
�acru Mcrlonnl.l
The forgoing instrument was acknowledged before me
this61 dayof_mou! 201q by
1_nrre Mrr1,.nr IrD
Name of pe son making statement.
Name of person makin�temen't
Personally Known c OR Produced Identification
Type of Identification
Produced
Personally Known_(, OR Produced Identification
Type of Identification
Produced
(Signature of Nota ublic-State of Florida I
(Signature of No ry Public -State of Florida I
CommissionNo.FT-R0g)aq zo`"."•r:: ea AUNEROORIGU¢VAZW
9
* MY COMMISSION I FF 2091
EXPIRES: Ma 16, 2019
�Oti3OPp� IDALINEROORIGU¢
Commission No. ., f MYCOMMISSIONI
* EXPIRES: May 1
o� et No
F
,
REVIEWS
FRONT
COUNTER
,reOii,d,, B
ZONING
REVIEW
ded Thum Budget NolarySe
SUPERVISOR
REVIEW
ked
PLANS
REVIEW
VEGETATION
REVIEW
OF
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19
UEL
)129
19
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