HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q 7n�
Date: Permit Number: I 10 U - o57zV,3
N77-7XIA1, SCANNED
• BY
Building Permit Application StLudl§COUnty
Planning and Development Services
Building and Code Regulation Division
-2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMITTYPE: Aluminum Wll'ilca (4- (c11L(L-I�
PROPOSED INPROVEMENT LOCATION:
Address:
Property Tax ID #: 3322-505-0096-000-7 Lot No. 87
Site Plan Name: VASILE-DAVILLA Block No.
Project Name: VASILE-DAVILLA
I DETAILED DESCRIPTION OF WORK: I
INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _Shutters
_ Electric _ Plumbing _ Sprinklers —Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction:$ /4i.7%2•00 Utilities: _Sewer _Septic
_ Windows/Doors
_ Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Fern G Vasile-Davilla
Name:
J- i C.ha 1 "3- NAW me441
Address:_ _7152 Maidstone DR
Company: { i wee(
e( JC L2-�Q�/i( U, CrIC- 1 I
City: Port Saint Lucie, State: FL
Zip Code: 34986 Fax:
Phone No.
AddrejIi��s,: I OqI SL J f�1 Y wag j+
City: fbbR S�• Ll.t Li Q State
Zip Code: 349N Fax:
Phone No 1-a— q31 3
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail bf $/I. Coto
State or County License ioto b,3
11 Ydluc Ql w1mFYGuon IS �?z2uu or more, a newrcutu rvouce or Commencement Is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:'
DESIGNER ENGINEER:
Name:
_ Not Applicable
i 2$
MORTGAGE COMPANY: _ Not Applicable
Name:
Addre� :
L UO3�
Address:
City: 1 (�
Zip: Phone
State:�
— �S;
City: State: _
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
otApplicable
BONDING COMPANY: _ of Applicable
Name'
Address:
Address:
City: - -
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVTT: 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 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 �Ytorney before
commencing work or recording vour Notice of Commencpmpnt- n //
4/
Signature of Owner/ Lessee/Contractor as Agent for Owner
SIgnattilre of Contrac or/Licr se Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST LUCIE
COUNTY OF +' I _U-Cl
The f ring instr ent was acknowledge before me
The forgoing instrumQ"Q(ynt was acknowledged before me
this ,day of 20I by
this30dayof /11I-..20Aby
Fern Va i I&
ti {c e(nav N4l-wr ezo
Name of person making statement.
Name of person making stptement.
Personally Known OR Produced Identification X
Personally Known ' OR Produced Identification
Type of Identification
Type of Identificatio
Produced DRIVER LICENSE
Pr uced
II __
(Signatur f Notary Public-
ignature o Notary Public -State ofI7ANiELA
BORSODI-BIRMINGH
No. 249625 -"�`
Notary PublicStetCommission
//++�� [ /2�:�eoHui mmission No.C-16 � I Y3Y Francene New
.i Commission # GG 249625
My Commission
Expires OSr231202
•.,o. r,.:' My Comm. Expires Aug 16, 20
2 aw
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National Notary
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