HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONS. cw
`yy
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO�BhiE� ACCEPTED
Date: 5 1 SCANNED Permit Number:
BY RECEIVED
St. Lucie Goa*
Building Permit Application MAY 17 9019
Planning and Development Services
Building and Code Regulation Division 5T. LuEIE.Goenty�. RarmltEIng
1300 Virginia Avenue, Fort Pierce FL 34981 /
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential ✓
PERMITTYPE: q '6I
PROPOSED IMPROVEMENT LOCATION:
Address: 1 V I& 7 / fJC -(! 17A 1 13k- /A / Ato
Property Tax ID #: — — 0 r�(' — Lot No.
Site Plan Name: LI i i - I) �� crib b Block No.
Project Name:
Additional work to be performed under this permit -check all that apply:
MecchhTical _Gas Tank _Gas Piping _Shutters
_Electric _Plumbing_Sprinklers _Generator
Total Sq. Ft of Construction: 1� Sq. Ft. of First Floor:
Cost of Construction: $ 2100 Utilities: —Sewer _Septic
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: o T
Address:109!51 S,
Company: Jji5,. c -./eeF 4:�-0..r
City: / 9 State:04--
Zip Code: 2_ Fax:
Phone No. I P -70q 8/301
Address:? 03 •o9G o,> Vvd ,e-l
City: /y State:
Zip Code: _O ,Ale3 Fax:
Phone No -a /- P= 7pE�
E-Mail: ST�r�Lt/�Ld / 17E�
FIII In fee slmple Title Holder on next page (if different
from the Owner listed above)
E-Mail %Gl-e 107� GL /;V
State or County License 4:zBzf44-Ffs3
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.
J/
(l�
%ti
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State: _
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
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
:e the permit holder to build the subject structure
or•and covenants that may restrict or prohibit such
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 )RJJEE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU WEN D TO OBTAIN FINANCING, CONSULT
WITH YOULEFIDER OR AN,ADTORM BEFORE RECORDING YOUR NO= OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Tignature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORID�A
COUNTY OF �l�t.If�I &CaD &
COUNTY OF VV !�2 _
The fo ping instrument was acknowledged before me
u
The r%rg instrent was acknowledged efore me
this f day of �a.t 20_l by
this ay cr 20 by
n�,ody,ot� -d" C(J.0� T�-
`4. ,ah r)Ct-
Name of person making tement.
Name of person making tatement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
„ti'v pia,• JACQUELINE D MULLEN
Notary Pu6Nc-Srate of9odda<� Notary Pu6hc-Srate of9orda
:NEDMat
(Si t Notary blic-State FDnt,,1dA JACQUEu
=x°a ;-_mac'•_ Notary Public-StatedF
�`�
e
(Si tur N�taryP H�' mF�����)EspresMar142o21
'•'.?0, ?1`
g ad„ 4 Na'im171 nmzrvAs�,
"I) Commi
Commission No. rc
Commission No. 1'u•31 Exoir sMar9
:� My Comm. Fxdres Mario
?�'orc��:�gp�pdgm�gANaliOrdN
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/1/19