HomeMy WebLinkAboutBUILDING PERMIT APPLICATION-.r
All APPLICABLE INFO MUST BE Cam: -_ :.ETEb F
Date: 3
,
Planning and DevelopmentSenam
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 349a2
Phone: (772)462-1553 fax: (772) 462-1578
IR APPLICATION TO BE ACCEPTED c� '
SCANNED Permit Number,
BY Flon
ECEIVED
St. Lucie County
Building Permit ApplicaY 13 _019
Commercial
ST.
PERMIT TYPE:
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PROPOSED IMPROWMENT LOCATION' '
4ddress: /S?i
Property Tax ID #: /r//V --7.6 / -O // R- Om/G Lo[ No.
Site Plan Name: G'1pC'lfeS emu.¢ cg.ri3' / Zile l$ L.�r-,F Block No. /OVA
Project Name:_ its. W4/ /S73;
CONSTRUCTION INFORMATfON s ' _:, s '"': '��
Additional work to be performed under this permit- check all that apply.
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doom
_ Electric _ Plumbing —Sprinklers
Total Sq. Ft of Construction: 456 54C
Cost of Construction: $ 33.7A'
_Generator _Roof Pitch
Sq. Ft. of First Floor.
Utilities: _Sewer _Septic Building Height:
%PWNE r
CONTRACTOR: rI " ;3 f,*
Name—dy Ay �P.nw
Name: l-CS/°(J.eJ92 lr,k.ai
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Address: �svi.. i., •• /-7
Company: `�'sw✓/ijlu.rieZ/.rJ'--
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City: /",41 -9*a T/ = a Fl • State. _
Zip Code: - Fax:
Phone No. %7a-41%-/l.nZZ
Address:
city:_yVAiw6....
Zip Code: 9?-,5r6
Phone No
State:lcl-
E-Mail:
Fill in fee simple Title Holder on next page(H difererd
from the Owner listed above)
E-Mail Si�vX fi ad.n
%1eT O//%
State or County Licensecc /s-J.E:iv/
•�� .+,��+.+�.. nncwmr... macems.ommencemem R, regWrea.
Ifvalue of HVAC is $7,.500 or more, a RECORDED Notice of Commencement is required.
UI:bIUNGNyentalNbER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: 72� &�64eze "o Name: — `
Address: VI .:fr 4n�Aid Address:
Gty: Alrn4,s State: City: ' ' State:
Zip: 3VZVA Phone Zip: - Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable I BONDING COMPANY: _Not Applicable
Zip: Phone: I Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
1 certify that no work or installation has commenced prior to the issuance of a permiL
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 Aswoation rules, bylaws or and covenants that may restrict or prohibit such
striumm. Please consult wdh your Home OwnersAssociation and reviewyourdeed 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 OtTRME YOUR FAILURE TO RECORD A NOTE OF CO»NCEMEYi MAT RESULT W YOUR PAYING
TWICE FOR IIPROVEhMMM TO YOUR PROPERTY. A NOTICE OF CONNENCEMEBi MIST BE RECORDED AND
POSTED ON THE JOB SLATE BOOM THE FMST RISPECODIIL IF YOU WXENID TO OBTAW FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECOROBNG YOUR POnCUMF COMMENCEMENT'
Signaturea�/ JContraGor as Agent for Owner
Sigbabtie of ContracWr/Liconse ftMer
-
STATE OF FLCTJ
STATE OOFFLORIDA„
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The forgoing ' strypent was admowledged before me
The forgoing instrument was acknowledged before me
this 1. day of 20jftby
this J__day of 20t%by
J ae, wwyI
s./{.,�„ /►
Name of pmaking statement.
Name of person malting statement
Personally Knawnv_*� OR Produced Identification _
PersonallyKnown OR Produced Identification
Type of Identification
Type of Identification
Produced
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