HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE CO!Wres� FED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: I l�J�'�atiJ
S L xll «t 7 SCANNED RECENED
BY MAY 10 2019
St. Lucie County
BuildingPermit A lication
FBrmft'In9 Department
p p �t, �us,p Guunty
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential O
PERMIT TYPE:
P12V: pncr—t11NPR[1VFMFtVT'InrATI(TN*,°' 1. 6" IT ". "',
Address: �6 `111�VI DG JC�VCA- 1��-
Property Tax ID #: l 01 . ��nS •O�J�1 ' 000;3 Lot No.-7-3_
Site Plan Name: Block No. 55
Project Name:
CONSTRUCTION INFORMATION: w
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 Pitch
Total Sq. Ft of Construction: O 10 Sq. Ft. of First Floor:
Cost of Construction: $ / goo L7 Utilities: _ Sewer XSeptic Building Height:
OWNER/LESSEE:; '> ..
CONTMgTOR:
qn
Name
) 1eo
Name:
�7a
Address: ys `f.�O7) 9J� CN
Company:
City: ''\' IerG2 State:
ZipCode:3 f�j fax:.
Phone No. Z - .13 77Z5'
Address:
City:' State:_
Zip Code:' "' Fax.
`.Phone No •+., -
E-Mail: MhOe) Z & iiiCo
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.
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
is in Home Owners Association
which conflict with any applicable 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
commencin work or recordingour Notice of Commencement.
"�' &� / k
& ,
ev.
F;SUPPLF�?IENT LGOIVSTRU
N UEN•LAWINFOR�ttYlATlO
w
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
� Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
[Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
k
Signature of Owner/ Lessee ontractor as gent for Owner
Signature of Contractor Licens o
STATE OF FLORIDA _
STATE OF FLORIDA
COUNTY OF �.�..u•,Il ,
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this _c day of 20_ by
this _� day by
�of�.�� 1.20_
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identific lion
Type of Identif cation
Produced �
Produced ��
(Signatu a of Notary Public- State of Florida)
(Signature of Nota Public- ate of Florida)
Commission No.
"`•"•°`•`t�;y IASFUWNgING � ING
Commisslon No. =�'• �- j�
MISSION
g • tpgl{ptINAINGRAM• RAFiMING
:.. fi GG 2I50G0
MISSION N GG 275060
p: EXPIRES: December20, 2022
:%F•..,.pP.
EXPIRES:
cembe
...•.,,
x
enmters
SEA TURTLE
REVIEWS
FRO '••;gai:
)Mae
PLANS
VEGETATION
MA ROVE
COUN
REVIEW REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
� IL{ kCJ
DATE
COMPLETED