HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 `\ �1 \t
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 Number:
SL NNED
By RECEIVED
St. Lucie CouMj JUL 1`•8 2019
Building Permit Application
sT. Lueie c_auixrt Permitting
Commercial Residential
PERMIT TYPE:
Address:
Property Tax ID #: MI 4 — 7-bV- — 0002 — a0�9 Lot No. i
AA
Site Plan Name: /G�vt,�iN5 19LA 0® Q� f, Block No. 4
Project Name: �1-912A-V S*
i
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank Gas Piping
_ Electric _ Plumbing —Sprinklers
Total Sq. Ft of Construction:
RM
Cost of Construction: $ I54?00. 00
_ Shutters
_ Generator
Sq. Ft. of First Floor: _
Utilities: _Sewer _Septic
Address: -7zloD to Fz'"/'g/L 5-T
City: ,U./-+441 State: �L
Zip Code: Fax:
Phone No. 7%` "S719 ^ 44
E-Mail: Vol-le990-5io)?homzs- ebvn
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: A-,
Company:,
Address:
Windows/Doors
_Roof Pitch
Building Height:
City: 0121/14/ State: FL
Zip Code: 3J/ 775- Fax:
Phone No 7S6 - 3q# —3855
E-Mail r^eyes'Iy/edoa@ y shoo. de'on
State or County License
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.
PUP. PL 5M ENTA GO -SU
DESIGNER/ENGINEER: _
Name:
O E
Not Applicable
IN
111
-OR A ION
MORTGAGE COMPANY: _ Not Applicable
Namei
Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip:, - Phone:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPANY: _Not Applicable
Name:
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 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 RECORDING YOUR NOTICE OF COMMENCEMENT_"
Signature of Owne Lessee/Contractor as Agent for Owner
Signature of Contractor/ tense Holder
STATE OF FLORIDA ` nn
STATE OF FLORIDA
COUNTYOF (9GCX 4e
COUNTYOF_
The forgoing inru ent was acknowledged before me
The forgoing instrument was acknowledged before me
this i-I day of 20\� by
this 1-6 day of _SV tV . 20_ft by
ki-t✓0\A.
Name�of person making state ent.
Name of person making statement.
^
Personally Known OR Produced Identification V/
Personally Known OR Produced Identification
' ic
Type of Idenation
Type of Identificaq
Pr ced
Produced
moo,...• OMNA COLON
Commission N GO 2508
D(PIRES:August 20, 202
(Signature of Notary Public-aaState of orlda)
(Signature of Not a gti,`S a e C C:NFNS
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REVIEWS
FRONT
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SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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