HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFOMUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED 1
Date: -i �� \ C(+AA w) Permit Number: -o a rr •—
• St. t_uce County mi
--�� - ----. Building Permit Applica on
Planning and Development Services ST. LuCount),
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential.
PERMIT TYPE: ipo` o k4 F-Veaj
PROPOSED IINAPROVEMENT LOCATION:
Address: /-/7 2a s% AM -
Property Tax ID #: l'+14 C0041 - Lot No. �
Site Plan Name: Q, (._VC- J5 I61A+t/D PJa6SAZdi3 Block No. A-
ProjectName: A0-0A'V63TAr
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _Shutters —Windows/Doors
_ Electric _ Plumbing _Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: cQ EO Sq. Ft. of First Floor:
Cost of Construction: Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
Name
CONTRACTOR:
Name: A%,-?MA0PD le6YO 7VL6-nq:>
Address: 7ei00 w
Company: AIVA42- CeYb3y�:t/:?Y1-�.c.�
City: /"t~/ State:%C-
Zip Code: 33«�4 Fax:
Phone No. -786 -'g-y- qya
Address: 0312o S40 'EkD SY
City: W-AosU State: FL -
Zip Code: 33/� Fax:
Phone No 7-96 - 344 —3,95a
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail roue ��2L}?t7G@ ra boo• �dr !
State or County License 1511 +3
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.
LauEMENTAL CONSTRU I@Ti
ION ILIIEN LA I IORM
TIO
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 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 Owner/ Lessee/Contractor as Agent for Owner
Signature of Contract o /License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF C-1C G a
COUNTY OF S}_ LOc',F",
The forgoing instr ment was acknowledged before me
"l
The f going instrument was acknowledged before me
this 1 day of _,�u^1� 20\by
this day of S y t`� 2(A'1t._ by
1'l(r'.�C�Q �11'-%gcn
d.tw.w,n�a �oic4b
Name of person making state en .
Name of person making statement.
/
Personally Known OR Produced Identification V
Personally Known OR Produced Identification
Type of Identification aou?;!�ert, DANNA COLON
�l✓
Type of Identification
Produced L �f-s_CommisslonYGG250804
Produced
, 2022 BondeOmmeudpetxmatP smvkas
D(PIR ES: August 20, 2022 amp RW
.
'1'�
� ',.. ._ �
p:ANNAI�MsAPoE GN p SU2S
(Signature of Notary Public- State of Florida)
(Signature of Notary,�" b,1ic' t$'E•e ofwf6i � .-'Mp-rts,20zo
Commission No.�25O�� (Seal)
' a: '.�,aNCe
Dp�:hficUndervnit�r'
Commission No. CT -�+=t Boec
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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