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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / I o D O �� Date: , / ty �I? LI {q Permit NumTation " tECEIVED SCANNED ,.�,__ BY o St. Lucie County _ Building Permit Appli JUN 4 2019 Planning and Development services Permitting Department Building and Cade Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 St. LudelCounty, FL Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial riebwential PERMIT TYPE: (� � � Address: Property Tax IDd: --IQI-cot —coO_l Lot No. LA Site Plan Name: T J Block No. _v'5 Project Name: Additional work to be performed under this permit - check all that apply: Mechanical _Gas Tank _Gas Piping _Shutters ✓Electric ✓Plum�bling _ Sprinklers _ Generator Total Sq. Ft of Construction: C i0g Sq. Ft. of First Floor: _ Windows/Doors ✓ Roof Pitch Cost of Construction: $ I ob7u, DD (i./y _ Utilities: _ Sewer _ Septic Building Height: ©�VUNER�LESSEE� rw ,�� P a p_ i COTRACsT�R�� 1 v';i Name AftMfk n%/ofNoMwestMnda,lne Name: A&=Hcaw$0INorlhwestFkxida, I iam Bry A Address: � GNA-W / A4. Company: Adams Homes ofNordnrestFlodda,111A City: q W G A*gzF State: iL— Zip Code: 3?�_3 Fax: 05D•`l34..SS83 Phone No. 81� • Cf-' - OLM) Address:3COC) (S*ucP 1944. City: 9_i1L E f>< State: �L Zip Code: 3 5 Fax: . 95. 5533 Phone No `-5o . 934, 0410 E-Mail: :RStae.fm;-tS @adcr7%3hcmeY Com Fill in fee simple Title Holder on next page (if different from the Owner listed above) EARN AE�[h�yr�p�q CCan State or County License CMt3DIL16 r�OF R- n value of construction is $2500 or more, a RECORDED Notice of Commencement is required. If value of HVAC is $7,S00 or more, a RECORDED Notice of Commencement is required. �SIiJPPLEMEN7rANCRONSTRUCTI©N LIEN I�AT°r'INFORMAiI1O�N l� PEN ;'` Q � `f "` - `� k Y;j�%! �"J 44�t.�-i}S�i?T� Roy fi._: IS` r3.L�'�'F,Vae DESIGNER/ENGINEER: Applicable WR�M1S}ii/±t'H%/hi4Y".CPT�YS,1i) gllt IS.j1 bCJ. �...o-,. .a ..l i _Not MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Applicable Name: _Not Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER] LUIv I KALIUK AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work dr 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RE[nRotNr: vrtnR Iunrrrc nc rnumcurcmr., n -- �� �fZt31G>=mr Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDAC� COUNTY OF The fo� going instrument was acknowledged before me this.-Ldayof _ 5_Ay)e, .201!� by William Bryan Adams f4tj�sIDtvr Name of person making statement Signature of STATE OF FLORID COUNTY OF 7w The forgoing instrument was acknowledged before me this L day of "�.tY}e . 20L by William Bryan Adams, ( r I w- Name of person making statement Personally Known OR Produced Identification I Personally Known_ OR Produced Identification Type of Identification Type of Identification SHELLEYA.SEPULVED - .w.. SHELLEYA.SEP MY COMMISSION k GG 26 �j ` MY COMMISSION S EXPIRES: lenuary25 r_EXPIRES„lanuaq 15fgrfature of Notary Public- Ita Cam=rr ture of Notary Pu a Commission No. cyy�f62c-l4 (Seal) Commission No. !Z�A�* (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED o„