HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5 Permit Number:
SCANNED RECEIVED
BY
"''co'
MAY 13 7019
Buw ding Permit Applicati n
af. WOo county, Permitting
Planning and DeveltrpmentServlces
Bullding and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
Residential y
IPERMIT TYPE: <<j( GIQ fi'!!9(1{I4 (�SidQvjee - r'ernodA f jfejUk1 - -
• • • PrG2:�itLllfi/.5i[/'Yfftril�.�ls�i'�•n�rt�l� ►�L•r!s•�<wiy�ilY.
Site Plan Name: Block No.
Project Name: &&Th tvmei d
MINNOWSU��x��aC4 �Ti0.��`�(�. F�Qss�,R- l�Y1 �1m0^('='�:q 'P 'Yi� l,�':.�. x �� y�t,.:"�;-i_.aih-''�t�+..� � , • ,`9 jjt�u;i�.� sz.�;5 -.T�z3�r�. t'--<�yy-��kKtiFFv�'
Adnal work to be performed under this permit -check all that apply:
7Mechanical _Gas Tank �asPiping _Shutters —Windows/Doors
_Electric Plumbing _Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:'� LtRemoGel - 0 chAtgr. Sq. Ft. of First Floor: Qem,od¢/ - O C i Ianzj e-
Cost of Construction: $�;cJ`Lg Utilities: ✓Sewer _Septic BuIldingHelght: dCha492
u,Q R L S W E q�.' K t N
110 RMI W
Name VS I+-
Name: Pdbier{- 0. Dt�tl'1�
=
Address:. T1q'A9 P(Ctfl+7,-"Ofl
U i N
Company: Pun /
lap I.Dnd. k(&45n
, U C
Clty: 'p( --i ct+. wd(L
Zip Code: ?�t i q8% Fax:
Phone No. gtVi-4(03';�59t
State: -EL-
Address: 1709 60 bf'kt e
4a, y
City; Up" Qndf.
Zip Code: 329/v0 Fax:
Phone No-?3o7-,5(o%7200 or
State: —EL
77aysv-Q6gq
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail Cif w e) CAun ILI R-COrLS}rlt(V0n. C6A
State or County License C CC 152 583 �,
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.
DESIGNER/ENGINEER: =Not Applicable
Name:
MORTGAGE COMPANY: _Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
state: _
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
of Applicable
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.
no
build the subject structure
ime
Wiichtma as prohibit such
Y apply.
In consideration of the granting of this requested permit, I do hereby agree that 1 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 ack itlons,
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 YO NT OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING Y URA cE OF COMMENCEMENT."
' naturenfr caner/ see/Contractor asAgent for Owner
Signatueo ctor/LlcenseHolder
STATE OF FLO A ,
STATE OF FLORIDA
COUNTYOF l/1/%!�f1 /11 uyr
COUNTY OF ���{rarA ver
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this Q day of 2YIQ LI 20� by
T—
this day of 20[I by
OSe.Q h /fi IW I-SM
bL " 4 o
Name of person ma ing statement.
Name of person making statem nt
Personally Known OR Produced Identification ✓
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Produced FL (iL/J l f/Co,20'�f9i3 53-293 0
Prodduucccee�d
n
(Signature of Notary Public -State of Florida)
(S gnature of Notary Public -State of Florida)
ro+N�; Puerc LAURIEACHAD
Commission No. C:�730GC1 ell) Commission#GG
LL ' �µ`Y' LAURIEACHADWE
mmission No. � 3V� � Set6misslon/GG309
Expires March 10, 2
�k
23 m Explres March 10, 202
Q
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2///3.9