HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPTMD FOR APPLICATION TO BE ACCEPTED ((�� 11CC
Date: Permit Number: AQp low
_. SCANNED
a BY
St. Lucie County RECENED
Building Permit Application JUN_06 1019
Planning and Development Services De artment
Building and Code Regulation Division Permitting P
St. Lucie county
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: /703 Aesr=b A✓e
Property Tax ID #: Lot No. Vmlz f3" t
Site Plan Name: Block No. /Y
Project Name:
_CONSTRUCTIO'N INFORMATION:
Additional work to be performed under this permit - check all that apply:
✓Mechanical _Gas Tank _✓Gas Piping _Shutters ✓Windows/Doors
2
✓Electric AL/Plumbing _Sprinklers _Generator Roof �Pitch
Total Sq. Ft of Construction: 2.5'01 Sq. Ft. of First Floor: Zs-O /
Cost of Construction: $ 467 006.00 Utilities: Sewer ✓Septic Building Height: /1/-G
'OWNER, LESSEE:
CONTRACTOR: * .
Name Dof LN'
Name: 1
�U
Address: 29`T,S AAinigwL Sr
�LL
Company: t'aT� w 64 of 4&c _
City: F7 State:PL.
Zip Code: 3 `Y9 2 Fax:
Phone No. 772 - 2Ib S/.! 8
Address: 517H 1Pi15-E701r 7?-L--
City: for{- P:erCy_ State:__9_L
zip Code: 3L/Q51 Fax: -77Z• ci61V • OZ Z
Phone No '7-77-- (oIg - 36-77
E-Mail: /NfALf 69 of�LE/DnSe�Y. EDnt
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
_
E-Mail�b"141aQ'bay (taws.e QIt •�K r
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State or County License CGc 152'4 530
30052
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.
v Not Applicable I MORTGAGE COMPANY:
Name:
Name:_
Address:
Address:
City:
State:
City:
Zip: Phone
Zip:
FEE SIMPLE TITLE HOLDER: vi Not Applicable
Name:
Address:
City:
Zip: Phone:
Phone:
✓Not Applicable
BONDING COMPANY: Not Applicable
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.
St. Lucie Count 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 RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Contractor
,iticer6o,liolder
Signature of Owner/ Le ee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 571r L_,,,,e,: a
COUNTY OF �- LALGc
The forgoing instru t was acknowledged before me
The forgoing instrument was acknowledged before me
this p day of t4A C- 201A by
this le day of Jvfw- 20 1
_I by
Msa '2>0"�
Name of person making statfement.
Name of person making state nt.
Personally Known OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identificatiq
Produced
Produced
(Signature of Notary Publ'
(Signature of N
•q li:;"> DAVIDYGUNO
A
" •'•`: ;, KATHLEEN I "C3P"1N
+o
Commission No. ' ! COM1SftAGG339770
;.:
Commission
:< :; MY COMMISSIONOf {�5931
p� + EXPIr88dW83,Z023
•,.` EXPIRES November 16, 2019
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