HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPL4. .,,,FOR APPLICATION TO BE ACCEPTED Ia�ZI
Date: DAqI Permit Number: r
_ �LBY RECEIVED
ARiN�
a �, •` - , LIudecoanty JUL 3. 1019
-_ • Building Permit ApplicationrfftfngDepartmertt
Planning and Development Services it. Luce county
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT PE: S�7
-DRr1 D!7Ffl "I RIDRAIlFRA FRITIr1fiATIL1RL• -' - -- -= - �
Address:
PropertyTax ID �Imp, — _I — oop -1 �1 Lot No.J�
Site Plan Name: Block No.
Project Name: La :no (' Or) P[ 2a6.
TAILED DESCRIPTION OF WORK:
��-itY'a,y,-. - .� • �C—c�-l}� '- c� Cc21., UC�0.CQ
04NSTRUCTION1NFORMATION:. '
Additional work to be performed under this permit -check all that apply:
Mechanical _ Gas Tank _ Gas Piping .,Shutters Windows/Doors
Electric Plumbing _Sprinklers _Generator TRoof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: 1 qU0
Cost of Construction: $ Utilities: _ Sewer 7%k Septic Building Height: l iD
'OWNER/LESSEE:
,�
CONTRACTOR: '
Name LccJ
Name: lsJo�rQ_ �VLA�I�e�l��
Address:3366 c�eow.� 6 -Se-
Company: I.sJJNz�, C-(-C..
City: State:_
Zip Code: -)`tf-llb
Phone
Address:0
city: rode State: NC.•
Zip Code: 0i71Lk( ii
Phone No 17a-qS3- 4f 14 3
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
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 19 required.
SUPPLEMENTAL CONSTRUC t � l? LIEN LAW. INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
.. _.r."
MORTGAGE COMPANY:
Name:
...
,X Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
14Not 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 mayapply.
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorn y before
com ' cwor or/recording vour Notice of Commencement.
Signatur of 9 ner/ essee/Contractor as Agent for Owner
Signa ure of Contrac r/Li rise Her
STATE OF FLORIDA
STATE OF FLORIDA -
COUNTY OF
COUNTY
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this . day of20 by
this �dayofCX J20-by
Name of person making statement.
Name of person making statement.
.�
Personally Known OR Produced Identification
—�
EN D'ONOFRIO
Personally Known "1 o %gg&961y1237558
Type of Identification
dentification I ` •s EXPIRES:AuguWCUrder
Produced ;••;��;•••.,, KARENVONOFRI
a,
Prodd s-° e. Na�ypubGcUMeW'Mm
MY COMMISSION # GG:37558
J'C'
EXPIRES: EXPIRES:August5,222
' F edilw Nohiy PubOcU
IL
(Signature of Notary Public- State of Florida)
Signature of Notary Public- State of Flo "Id' )
Commission No. �� 1SS�S (Seal)
fi •^" D
Commission No. �iS 'I; '" fir ea& KAREN 'ONOFi�
COMMISSION#GC
EXPIRES:August5,
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