HomeMy WebLinkAboutBUILDING PERMIT APLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6`\1�1T_ t;(;ANNED Permit Number:
BY
St. Lucie County RECEIVED
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit ApplicLtionjUN 17 2019 County, Permltting
Commercial Residential i/
PERMIT TYPE: Poo l 6cL#- fer ken Ce_
Dononci=n-iKADRnVPMFNT i,nrATInN:
Address:. /,_1& `✓`Jroc-k 5mt+hyoazi, F"i- he"rC_e FL
Property Tax ID #: f9.3 c2 9- 457-6r2" 1000 (0 - 006 Lot No.
Site Plan Name: Ne 5i-eX Block No.
Project Name: /-i c54cr
`CONSTRUCTION INFORMATION
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
_ Electric _ Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
CostofConstruction:.$ rl6tft) Utilities: _Sewer _Septic
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE
'CONTRACTOR:
"
Name f
e5fer
Name: LI h JCIhm
Address: 0� /P_1tlQr
IDrIoe
�t
Company: Spa % Fc1Ce, OoMpan y
City: F}- P,, ii/ e r^C e.
Zip Code: 47'?8/ Fax:
Phone No. % 7.2 - � (,o%-
State: FG
*// �7
Address: Pry & K ab( 3
&
City: S4_LL� /'_"
Zip Code: 3-'T% 5__
Phone No i -79 --1-off- /
State:LpL�
Fax: 77.,2 .199 cJth �
15-/
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail 5'IaArlVerloQ Ripe
it 6 ou4A , ne- -
State or County License cP-O
F_7k
If value of construction is $2509 or more, a KEcoRMIJ Notice or commencement is requueu.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCiIOIV LIEN LAiIU INFQRMATION
x.
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
—Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
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 Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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 01�4MMENCEMENT."
as Agent for Owner I Signature
E OF FLORIDA STATE OF FLORIDA -
COUTNTY OF M L r-k n COUNTY OFJ11_C" 0
The forgq,ing instrum nt was acknowledged before me The forWing instru ent was acknowledged before me
&— thisdayof \J .Yt — 20—l!j - by thisdayof J Wle 20—iffby
.cii
Name of person making statement. Name of person making statement.
Personally Known �OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
t Q L /A ! Ll lilt 0 .G L
(Signature of Notary u G a (Signature of Notary
�V" � Notary PubNe St910 of FIDrICe d� � uuddr��
�G se57ot " DBnre K 86F a Pbr 0a
Commission No. ' 'Ji ray m Commission No. j Commtsabn Gr. 285701
REVIEWS I FRONT I ZONING SUPERVISOR I PLANS I VEGETATION I SEATURTLE MANGRO
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW