HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLET2 "rOR APPLICATION TO BE ACCEPTED
Date: SI I y ��`� SCANNED Permit Number:
P BY
St. Lucie County
Building Permit-Appi
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
PERMIT TYPE: S-�eQS ���a�v�oi
Address: G) e'6 JC!.4 t
Property Tax ID #: ta- Cc " Cs i o - 603g'_
Site Plan Name: -avvtas Qc-c Q_cS
Project Name: Ajogm6m4%
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Additional work to be performed under this permit -check all th'a:
_Mechanical _ Gas Tank _ Gas Piping
_ Electric _ Plumbing _ Sprinklers tl
Total Sq. Ft of Construction: Sq.;Ft:;
Cost of Construction: $ 0• 0 b utilities:
0 S-035S
MAY 14 ?0i9
LucieLucie C�rmitting
Residential
Lot No.
Block No.
-Windows/Doors
Roof Pitch
_ Septic Building Height:
OWNER/LESSEE: r
CONTRAC7AR:"> '
Name Lin-v,N� f-S
Name:
Address Z LAe 4 ✓1
Company:
City: F r-\— �-_rc& State: Ed
Zip Code: q K Fax:
Phone No.® 7 q 46 14,37
Address:
City: State:_
Zip Code: Fax:
hone No
E-Mail: 'ft 11 k'ccw-, Cfo.0
Fill in fee simple Title Holder on next page ( if differentTE-Mail
from the Owner listed above)
tate or County License
If value of construction is 52500 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.
SURPLEM„„ENTAI COST
ION LIEN LAW INF
OR
p
DESIGNER/ENGINEER: _
Name:39- �n a l�Ja�.
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Addre s: fC:%Sb 5. (Ai s. l
VA r
Address:
City: Min r- ' S t 1, Lm. % .
Zip: A S 3 Phone �riaa'
State3 E ((_
Y'>>T- gay
_
City:
Zip:
Phone:
State:
FEE SIMPLE TITLEHOLDER: _
Name:
Not Applicable
_BONDING COMPANY:
Name:
_Not 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.
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 norf-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 your Notice of Commencement.
ature df•Owrye rhlessee/Contractor as Agei = >a1
Signature of Contractor/License Holder
u 9
.STATE OF FLORI A =
STATE OF FLORIDA
COUNTY OF m
COUNTY OF
The f rg ing instrument was acknowledged befr$
The forgoing instrument was acknowledged before me
this xday of MIQ/4 b �
this _ day of . 20_ by
ff^^ y2�0
U l PC..I
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identifilm
Personally Known OR Produced Identification
Type of Iderifific o
Type of Identification
Produced
Produced
(Signature of NotV Public- State of Florida)
(Signature of Notary Public- State of Florida )
f
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 9126118
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CEIVED -I L Q
COPY 14 Z019
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FORT ?IERCE, FL- 3q945 TECH.
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St. Lucie Countv