HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED d
Date: •5 a8 SCAN��&rmitNumber `drJ'dSroq-
BY
3t- Lucie County RECEIVED
_-
Building Permit P
Planning'and DevelopmentServices ----
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 4624553 Fax: (772) 462-1578 Commercial -
n MAY , 2 20i9
ST:Cucie Cou' Permitting
Residential
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION:
Address:= IS R�/ A[W Sv-IHET Y iiu4�. C'►2; t�riLHn elry 7�L 35�cj9a
„i .. rwa ,.. ,
PropertyTaxlD:#:._ 9LJ( L6-i3O3'-oo31-1-000-1 i6�3 $�YO�,• YV'9 13otNo.
Site Plan Name: µaQgou'ie -606,c- SweoT $a "y'illA(TF$I ekNo.`II
Project Name: IS-9 4 _ lrz II,n•_
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Additional, work to be performed under this permit- check all that apply; ;
_Mechanical —Gas Tank _ Gas Piping _ Shutters
,& Electric X Plumbing _Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost'of.Construction: $ AR S 0-00 �� Utilities: -. ',Sewed ?l >`Septic
Via`°• 'yi•; �. _. .;^`. _.. �o •_
Windows/Doors
Roof Pitch
Building Height:; '
8 LESSEE:
E
CONTRACTOR r '
;
;S
'Name,P-, b 0 t1ND TVC_r- MAAE!X( 41A
:Nalpe idN`A2'E =F Ai/C:/ECE
a• A.'P10 ..i _
'Address: "Is8`/-..vvV 5.WEET' Ag.% ei/9:
Coiiipany:: EM`8Aq3:' ociiares LL'C.
..!:I�aCwr' i' T State: t=L
Aiid7 U iOv e 2
ess:__3 r' 11J D . 1
Zp otlg:,:3LI44O Fax: --
City +'7JIOI i�2 State:�L.
Phone No. I- tio3- 6a4 - A3) 3
Zip Code: 33c/6? Fax:
E-Mall:E;NALC-0f4AeS1(e1AQ- ( MAIL'. Cowl.
Phone No, 061 -•,YS- 9S9/ .
Fill in fee simpie Title Holder on next page (if different
_E _Mail A�bar CL'AEM i4NA ASSOCI Are-�', Co/I
State or County License CGC I Sol Toa "+
from the Owner listed above)
303
it vame of construction is SZ500 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.
SUPPLEMENTAL
CONS
IONi`LIENLAW'INFORMATI,ON�'�
,
DESIGNER/ENGINEER:
_ '- Not Applicable
MORTGAGE COMPANY:
X Not Applicable
Name: B&IA ! MASKOL A E,
Name:
Address: �a-5- SE 1.rT
S�;Nr Loale i3LVp
Address:
City: h'orT lz .: IT- L1,etE
State: FL.
City:
State:
Zip:34`I84 Phone
.ASS'. .5 a
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
_,e,- Not Applicable
BONDING COMPANY:
K Not Applicable
Name:
Name:
Address:
Address:
City:
City: `
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to dothe 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 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 i BE RECORDED AND
-POSTED ON THE JOB SITE -BEFORE THE FIRST INSPjrCTION. IF-YOU.INTEND TO OBTAIN FINANSMIG, CONSULT
- WITH YOUR LENDER OR AN ATTORNEY.BEFORE REeORDING YOUR -NOTICE OF COMMENCEMENT.- ' _
Signature of Owner/-Lessee/Contractor as Agent for Owner _
Signature of Contractor/License Holder _
STATE OF FLORIDA
STATE OF FLORID�q
COUNTY OFF Lucy
COUNTY OF �9 r7
The forgoing instrument was acknowledgebefore me
The forgoing instrument was acknowledged before'rne"
this�day�o/f 20 by
this /T_20_Sjby
A_2�Ldayof
Name of person making statement.
Name of person making statement.
��1Uhrr
Personally Known OR Produced Id�allt c �
to
Personally Known OR Produced Identifica.1c t+++,
Type of Identification, �� �� ti 9
Produced - aisf ° �5 �,U`J� ��::'�OTAgY .;'L
Type of ldentification�
Produced .✓,Y!!J°L 5 �.ly,� Qi� • p7Ag'
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My Comm. Expires :,
November 19, 2021 7
_ - �• MY Comm. Expires i
_�
November 192021
No. GG442512
- - — ;
112512 j
natur Notary Public- State of FIdY�� �• pOBC�G}'�0
not f Notary Public- State of Florida3; tP�•,
Commission No. (94 IL05) 2 (s�41 OFI P; �P`
Commission No. l'iyA5('2 (Seaf%;�,, OF IF �P
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MANGROVE
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REVIEW=
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DATE
COMPLETED
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