HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: (9�-'Ynn)' `"J• Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: e44_?�
SCANNED
BY
fit. Lucie Coun$
Building Perml Appl
Commercial
/yam - n 1 (e
RECEIVE
JUN 21 2019
c ion
Permitting Departmer
St. Lul:12LCounty, FL
Residential
Address: &v0V* . Hzr, _j Dr I t u✓(- Ptelce (EI 344P[ �Z
Property Tax'ID#�-1udZ-609-66 4� -000 -°� LotNo.S,(o
Site Plan Name: Block No. -70
Project Name: - 6000 «VJVVI�j
DETAILED DESCRIPTION :OF WORK:: <..
2 Car �w'� 9
CONSTRUCTION INFORMATIONt -
Addi 'onal work to be per2f ed under this perma� check all that apply:
_IVj�chanical /GTank �7GasPiping Shutters
/Electric mbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 7! CoO oD Utilities: Asewer Veptic
h7./82. ,R
endows/Doors
Roof 6 iL Pitch
i
Building Height: S
OWNERAESSEE:"CONTRACTOR:.'
`=
Name vlL--
Name: G
IAhc.
Address: b7 Aljrll�_
Company:
ft?a
�vf kJ r�
.
City: Fdr{ RL State: P%
Zip Code: 3R9is2 _ Fax:
Phone No. 771' 6.5q-c�q
Address: 26 $ 5 V SzOY' Q h
City: Porl 5 . Lyev,
Zip Code: 34gw
Phone No 777- _; 0
1 State��.
Fax:
`160'5
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail h iVO
mex; I . cpv%i
State or County License_
�L17 S�3Z4
it value of construction is 52500 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.
, '14
SUPPLEMENTAL CONSTRUCTIONIIEN LAW INFb MATl0N:
DESIGNEaENG NEE}/ of Applicable
Name: ®DS 7� d CIL
MORTGAGE COMPANY �j _ Not Applicable
Name: Stan LIU
Addre s: a
Address: ZR
JW r. 81
City:�< Umc State:
Zip: fi �r5 Phone�71 _19-St;;
City: Pu 5 -c State: I:
Zip: ;LM..Ci Phone: 77?- 67 -51s�
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Xddress: - -
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 County 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 T,,HHE JORSITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LQNDERIOR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
I � V14
6A,�
Sign u to of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF `��. LJUC
STATE OF FLO{QA
COUNTY OF LVLCI�
l�'t"
The for oing instrpment was acknowledged before me
thist�d�f J®,�20J1�. by
The forgoing instr nt was acknowledge before me
this,�dayof�J20� by
Name of person making statement.
Name of person making atement.
Personally Known �OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
ype of Identification
P oduced Pudic 54te of Florioa
r ced
otery Public State of f'io U
Louuen E Bevins
dMy Commiasi--'
Lauren E Bevins
MY Commission GO 260475
Ead�ea 99f;:
09l20R022
den
,�A
pM1� Expires
( ignature o otary Public- —ate oof Florida)
(i nature of otaryPu lic- t myl ri )
_St
Commission No. /�ISL0'T 15 (Seal)
Commission No. �' T (Seal)
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Rev, 21//Ei