HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COW- I'TED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECENT
� d
MAY 071019 a
Building Permit ARf,1. tion oe artment
Planning and Development Services Permitting P
euildmg and -Code Regulation Division
BY St. Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: ® �e>7 r-V4 orb.
,ems . t:, a. r i:, .T�
Site Plan Name: _
Project Name:
n
Additional work to be performed under this permit —check all that apply:
Mechanical �GasTank _Gas Piping _Shutters
Electric Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: % 1 S 5c)
Cost of Construction: $ �� wn s
Sq. Ft. of First Floor:
Block No.
Windows/Doors
_ Roof . Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:' =?
CONTRACTOR:
Name i
Name:
Addressv ai!DM Qkgj TwiO Lone.
Company,
City: ® khi-Ir 7PiPrda State: rn-L
Add ress:-
City: State:_
Zip Code: ' 3q 'I %L Fax:
.Phone No. ® ��%� �7�- (,AIA
Zip Code: _'-Fax:,
Phone.Kp
E.Mail: ®e_Qrl�):ll I Lb i1Ot_.com
Fill in fee simple Title Holder on next page ( if different
E-Mail
State or County License
from the Owner listed above)
If 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.
SUPPLEMENT, UC NSTRUCTIONa#.IE �I AW INFORMATION
..a
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: •
_
Name:
Address: ®
Address:
City: % State:
City: State:
Zip: % Phone I
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
®14CN �'
jl e O hV
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this 2�, day of C�\ o �le\� 20�ft_ by
The forgoing instrument was acknowledged before me
this _ day of 20_ by
Name of person making statement.
Name of person making staterrLent.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced_
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida)
0
Commission No. -""' • CHRiSAFRIONS
Notary Public -slated Florida
Commission No. (Seal)
PLANS VEGETATION SEATURTLE MANGROVE
REVIEWS
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F """
My Comm. Expires
p/,2021
SOR
REVIEW
COUNTER
REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
SCANNED �.
- — - - Building Permit Application BY
Planning and Development Services St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: 16 gCY7f'VA-f1 pry.
�,1�1l1,1l�CrR��Rl�,l nA/rl�`d Y[�T.. 1'AI`ATIIILL "••: �i �ii t.+F �i`-v�.a. . �} •k` i �4����'.�, � '�}'h�•.'4'.
Address:
Property Tax ID#:• 3Lg oS AC)I - OC71 D — o00 Lot No.
Site Plan Name: Block No.
Project Name: to
Additional work to be performed under this permit— check all that apply:
Mechanical GGasTank _Gas Piping _Shutters —Windows/Doors
Electric Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: ®t S 60 Sq. Ft. of First Floor:
Cost of Construction: $ '% Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:.
.CONTRACTOR
LL
Name ay ki1
Name:
Address+ Q Lpt)4 CSye j
To io
Lc\f\e
Company:
City: Y �" �j gy-da
Zip Code: ' 3�1 R N _ Fax:
Phone No.
State::
't '�I-
Address:._ �� .- .... .....
_ .4..;
City:
Zip Code:
Phone_No
State:_
.Pax; ;
E-Mail: . P-arC 1nL.Com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License
If 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.
A{:a�51' {, ., '
V
s Y( r :+ T1kf�*N
' rt� R' e` C : 9K•
... ..
C'%yt �'a'-"R
DESIGNER/ENGINEER: _
Not Applicable
:,}.
MORTGAGE COMPANY:
Not Applicable
Name: •
Name:
_
Address:
Address:
City: %
State:
City:
State:
Zip:. Phone 1
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _
Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
s
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 S�tructure
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,a:
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before 0
cornmencing work or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this :�_ day of o c�e�� 20�ft_ by
this _ day of 20_ by
Cm
V
D. -C\\i rC
Name of person making statement.
Name of person making staterr}ent.
Personally Known OR Produced Identification
Persohally Known OR Produced Identification
_�5<
Type of Identification
Type of Identification
Produced 2hje
Produced
ar
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida)
Commission No. :•^_ •. / I
S ��ONS
CHPIStIAc
Commission No. Seal
(Seal) �
Notary Public -State ofFlarida
-r rr. 141IS31s
"'Fare'
My Comm. EVp es
pt1021
REVIEWS
F
SOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
REVIEW
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.