HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: $ a$ 1A� Permit Number: �qOd 06r�1
SCANNED
c '` -1- BY
\ COUNTY -St. Lucierhinty RECEIVED
-- 0- - - Building Permit Application AUG 2 6 -,019
Planning and Development Services
Building and Code Regulation Division ST. Lucia county,. Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
Address:
Property Tax ID
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:'
CONSTRUCTION INFORMATION: ,
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: / 15'2
Cost of Construction: $
B0 O°
Lot No.
Block No.
_Shutters —Windows/Doors
_ Generator X Roof M 7 Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name VliS inY 4 hflde4te
Name:
tc C
Address: 02 vas 6 •, c
Company:
City: eG1ccf State: fL
Zip Code: 3 '3c/St/.T Fax:
Phone No.b / 7 '.-1791 —,2 393
Address: yg7 Y.
City: /'Y.4e/cc Stater
Zip Code: 3 y5W Fax:
Phone No _ 77.2 -.370 "562J
E-Mail: btt-ene o7S7le 14m,6o2n
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail e"me & t 49cs MQ"1
Ci-
State or County License C66
1520537
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.
((xlclp s@cMctkVCpern
ucalu 1-4Cn/cimul1YCCn: _ IVOL Appllcaoie MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: _Not Applicable
City:
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-"
6%LV'a 5��4�
Signature of Owner/ ess /Contractor as Agent for Owner
kul�y
Signat Contractor/License
ure o Holder
STATE OF FLORIDA
STAT OF FLORIDA
COUNTYOF I AAC�te
COUN F �S� -
The forgoing instrl��.\ment was acknowledged before me
The forgoing instrument was acknowledged before me
thisa,�(e�\\dd-ay of 20NJ by
J
th!Qik day of 26 0 by
�IC�SI�YI 1�cPPfIP
c�Qce��mnr�ln2
Name of person making statement.
Name of person makings tement.
/
Personally Known OR Produced Identification V
Personally Known OR Produced Identification
Type of Identification
-;p�6Sb
Type of Identification
Produced V-L, l7L - k\ 07 yQ -63y �b
Produced
/ AAji f� p,,nraQ
(Signature of Notary Public-S
gnature of Notary Public -State of Florida )
40 wsk Notary Public State of Fkxida
• j D Paschal
Commission No. (�
F MM Wim GG 293005
C mmission No. (Seal)
pC Eav11;e5 07/262023
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