HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONrA
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date; C0 ' Permit Nu W
RECEIVE®
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fait: (772) 462-1578
Building Permit ApplicationJuN 4 2019
Permitting Department
St. Lucie County, FL
Commercial Residential x
PERMITTYPE:OWNER BUILDER..:
�.
PROPOSED IMPROVEMENT LOCATION[" , �� , �) j!•I. � �'+? n'�.' ,,+i�I�
Address: ozu N rrra KU, r + MtKUt, hL'54945
Property Tax ID #: 2310-601-00.02-000-7 Lot No.2
Site Plan Name: Block No.
Project Name:
CONSTRUCTION INFORMATION: r ' `
Additional work:to be performed under this permit— check all that apply:
_Mechanical. _Gas Tank _Gas Piping.. _Shutters
_ Electric _ Plumbing o_Sprinklers _Generator
Total Sq. Ft of Construction: % a Sq. Ft. of First Floor:
Cost of Construction:$ SOOO,0O Utilities: _Sewer _Septic
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
�f
CONTRACTOR
Name,10SHUA R KURTH
Name:
Address:520 N FFA RD
Company:
City:FTPIERCE State: _
Zip Code: 34945 Fax:
Phone No.772-359-8966
Address;
City: State:_
Zip Code:.. Fax:
Phone No
E-Mail:FIREDOG730@YAHOO.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License _
it value or construction is , zbuu ormore, a_RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement t is required. .
',
SUPPLEMENTAL CONSTRUCTION_ LIEN LAWIINFORMATION1 IL:;
_.IVUL Hppncdole I MORTGAGE COMPANY: _ Not Applicable
Address: Address
City: Stater City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable I BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
City:
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
flaws or anScovenants that mayldrestrictbO prohibit such
your deed for any restrictions which may apply.
In 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Sign,�fdre of Owner/ Lessee/Co tractor as Agent for Owner
.Signature of Contractor/License Holder
STATE OF FLOF��IpDA
STATE OF FLORIDA
COUNTY OF J4- L U GI `4-
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 4 day of JUNE . 20_ by
this _ day of 20_ by
JOSHUA R KURTH
Name of person making statement.
Name of person making statement.
onallyKnown x OR Produced Identification
Personally Known OR Produced Identification
;,,Pei
a of IdentificationType
of Identification
uced
Produced
gi
nature 60 Notary Public- State of Florida)
(Signature of Notary Public -State of Florida )
M
M
mission No. FF912939 (Seal)
Commission No. (Seal)
9
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VEGETATION
SEA TURTLE
MANGROVE
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