HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �1�� 1_ PermitNurrlber: 1�dS�0\9a.
RECEIVED
BuildingPermit A li. ati
pp SAY 0 8 2019
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential L---
PERMIT APPLICATION FOR: F(nme SCANNED
FROPOSED,INPRQVEMENT LOCATION,...
r. St. Luc{e.c UntV .
Aaaress:
Legal Des
Property Tax ID #: 3.231) °;� o3 D O<c� 000 0 Lot No. 51
Site Plan Name: T6mas 12=9Jc12n--4 Block No.
Project Name: Rose and1 (6k�u -r--n5
Setbacks Front Back: 76. 3 Right Side: 2-D Left Side:2a
3o;(3 SF L I v1 n5 N3c;'o. To7-aL 6 F
perm¢-cnecx all tnat a
✓IGlechanical _Gas Tank _Gas Piping _Shutters Windows/Doors
✓Electric 1/Plumbing _Sprinklers _Generator --Roof Pitch
Total Sq. Ft of Construction: L/ 3 S 0 Sq. Ft. of First Floor: 3023
Cost of Construction: $ 517, 0" Utilities: _Sewer Septic Building Height:
OWNER/LESSEE '
_
CQNTRACTOR
Name ba-dn QoS�,
Name: h9feA" PrfrlonrrSly
Address: %038 Ma7elS• o"e Dr
Company: �%r"Francesca /IoxS i-n �nY+ we
city:. PsL
State: P-
Address: p'? If a l a� c Sbw z p r„ti t re l L
City: fli 91 -fZe State:_4l-
Zip Code: 34 q'86 Fax:
Phone No. '77 z. 320 — ZI $-/
Zip Code: 3414 S Fax: -77 Z d LJ65-78
Phone No,372- .Po l - 77f7
E-Mail: N/A
Fill in fee simple Title Holder on next page ( if different
E-Mail J i'C ra-rl eo ns4,f nc. (0- 2ol- , ee+^l
State or County License R R ;t9Do 3 611
from the Owner listed above)
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
PF
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
commencingwork or recordingour Notice of Commencement.
Rev.
S(1P�L"EIVI''~ENTAL`CONST
U TIO'N'
LIEN
t:%aW IIVFORMA'TION
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable ,
Name:th"ci„�-t�vn,Y �,m�
Name:
Address �Ro6 'DeLawmre R-o-{
Address:
City: FT Pc4-roc State: {-L
City: State:
Zip: 3yRsa Phone �7L 2fdU. `7Z�
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 5•sc.La��C
COUNTY OF Sk•l..ici-�
The foJgoing instrument was acknowledged before me
`b
The for oing instrument was acknowledged before me
�
this day ofW\ay . 20� by
this day of 1f'hd.� • 204 by
�•�Cn�R.` �•\T'Q o.'F\CA SGa
Y"'1chtl.a\ �D �'F`r CL v�CRSCa
(Name of person acknowledging)
(Name of person acknowledging)
(Signature of Notary Pu lic-State of Florida)
(Signature of Notaryublic-State of Florida )
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Ty a of IdentifLcation
Produced � t, � C—
uSec�..�•X��'�'S
1EGNEN
Commission NO. GCso�+Z+a• eal) � #GGB
?g'.•, O� 10 #GG 02?02;V jE
I O�}�?�IO.��2028 I� (Seal)
••g;; •.,, MISSION
+y°."s:•.. � MY PAES;Decen'�I Und
2�0
,wiM1 Nogry PubfcUnde^uiie�=-
Fo«<or Bonded Tlw b
�; � �rypubf�c
��
REVIEWS
FRONT
•�1jFef r\�eS B'i
O
PERVISO
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
IEW
REVIE
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
� I,
DATE
COMPLETED