HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLI,C BLE INFO MUST BE COME_, j,-D FOR APPLICATION TO BE ACCEPTED
Date,. t�/ Permit Number:
SCANNED
St. Lucie Comb ERECEVBuilding Permit ApplicationPlanning and DevelopmentServices
Building and Code Regulation Division
2300 Virginia Avenue, FortPierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential_
PERMITTYPE: SF7
P..ROPOSED`,IRIP ROVEMENTL•OCATION:
Address:
Property Tax ID I " (9 j I — 0 1 3 i " 1000— (7) Lot No.
Site Plan Name:
Project Name:
Block No.
D;ETAILED DESCRIPTION OF WORK:77
CONSTRUCTION 'INFORMATION'.- , I . � - • . .
Additional work to be performed under this permit —check all that apply:
%Mechanical _Gas Tank _Gas Piping .Shutters X Windows/Doors
Electric Plumbing _Sprinklers _Generator TRoof Pitch
Total Sq. Ft of Construction: ) 0 1 Sq. Ft. of First Floor: 1 joo
Cost of Construction:$ 1161 Utilities: _Sewer Septic Building Height: /(10
OWNER/LESSEE:. =
CONTRACTOR:
Name l_') L,
Name:
Address:334bb clet
Company: lsu5�� i LC
City: ��S�G�—Cb State: _
Zip Code: �`iy(d Fak:3��o'oZ�6a-3
Phone No. �`1a'�(53--1�1S7J
Address:3300
101
City: G
Zip Code:_(9�14(C)ga-
Phone No 'f 1 �.
State: MC..
3
E-Mail: Vpjen.Dos da.i)Q usdR SY k� •m
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mai ateN- ho
State or County License c -ii(_ a5`I
it 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 11 required.
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: —X Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Address:
Zip: Pho
�CNot Applicable
CONTRACTOR AFFIDVIT: ADolication is herebv made to obtain a hermit to do the work and installation ae i di,•.tad
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 be recorded and posted on the jobsite
before the first inssppection. If you intend to obtain financing, consult with lender or an attorney before
commeneirig woridor cecordinavour Notice of Commencement. , /J n
44�/,.
5 nature of 0 er essee/Contractor as Agent for Owner
Signature of Contract ense Hold
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF S-�. (mac c P .
COUNTY OF S� - L�zc �
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this ?� day of 201!� by
this _:EL day of 20_\a by
`
Name of person making statement.
Name of person making statement.
Personally Known _ OR Produced Identification
Type of Identification
EN D'0N0FRO
Personally Known *. qd oblWiM237558
Type of Identification 1
Produced
EXPIRES:August5,2022
Produced �''+• "' uom PUbr1CUnda*1RM
.. P:
(Signatu a of Notary Public- Stat
KAREN DONOFIR
Sign
re of Notary Public -State of Flo 'd )
Commission No.
MY 101MISSION#GG
mil) "ExpIFSES:August5,
7558
gP�mm
sion No.�,`f 5 S-S:' :`.•'p'�••�D'ONOF
•.+,po.°",: sandedThruNaaryPunUcU
ernuers
:.COMMISSION#G
�I'%•.�F ExPIRES:August5,
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA'tRILE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 9/26/18