HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONA.
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: !YN. scANNED Permit Number:
C' r St. LUCB G°OUi1tV RECEIVED
AUG 0 9 ?019
Building Permit Applica (on
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: / /a,T l/e Me-s Blvd 1204cv . �PG SWX-7
Property Tax ID #:
Site Plan Name:
Project Name: _
y 56 -,,. '�>01— \3\a-o4o-
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: I
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical _Gaas�sTank _Gas Piping _Shutters —Windows/Doors
L/Clectric "lumbi/ng _Sprinklers _Generator _Roof
Total Sq. Ft of Construction: /'7 nW Sq. Ft. of First Floor: _
Cost of Construction: $ 3(v., 000 Utilities: —Sewer _Septic
Building Height:
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name YIq P. R" S f�TT
Name: Ai rr� IAA TF
Address: hr'D, I3o 0 49"9
Company: Ll 't( e Dne-k t1,111whr
City:SQM1neHAA.) i<EN/ State:
Zip Code: 3�30 4a Fax:
Phone No. 305 ^ 6100 -R a 0 L7L
E-Mail: ke OGEf}AUmq e/L q
Address: Io dU fSeg5
H-VAt-
City: SuMM,or w.id k/
/Zip Code: 3 3 0 4 N, Fax.
one No 305— L 1S^=-1 240
State: L
Fill in fee simp a Title Holder on next page ( if di rent
from the Owner listed above)
E-Mail_ t4Tl e 9 I I 4ze+l en e bns;7 1l -I-S.
State or County License
LG--W1 I
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-
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: ViNot Applicable
Name:
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."
Sign Va of Owner/ Less/contractor as Agent for Owner
Sign r of Contracto tJLi ense Holder
STATE OF FLORIDA
ST TE OF FLORIDA
COUNTYOF 6�r. \.Oc:0Z
COUNTYOF %. L�1c\�
The forgoing instrument was acknowledgeV before me
The forgoing instrument was acknowledged before me
this *\` day of etas 20\by
this -4�- day of 4!"� 20}_ by
'S v V S 4\, a A+
'5 a \.,a. S V\ a-i+
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 Identifi ion
Produced \ fl t-'
II�
Produced L 'K� L
(Signature of Notary blic-State of Florida)
,,,(Signature of Nota yb i 1,
Commission No.GCz��-d'2. 'j (Seal eNru
N� 21g G c"
-,Commission Nd. O'3a,0a,
;YJ�.:.�-..
p
REVIEWS
FRONT
UCE_ &eSi7p
ISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
Itil)rt2'
IEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19