HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: S'� c� ) swermit Number.10*6
By mr-W
RECEIVED
ISO St Luciiel0numv
—_----- Building Permit Application SEP . 5 2019
Planning and Development Services Permitting Department
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie nty, FL
Phone: (772) 462=1S53 Fax: (772) 462-1578 Commercial
PERMIT TYPE:
PROPOSED IMPROVLOC EMENT ATION:
Address:
196,5 / /�1 u S�nCt�D f S Vc.
PropertyTaxlD#: o 4 - 00(0?'--O0Q-7 Lot No.
Site Plan Name: PFOW64-� tz"\C ; Block No.
Project Name: nl�
DETAAILED DESCRIPTION OF WORK:11
1, � (� :II Fir.,•. o,,.. � �� r o, n,t�a IFS' 1�,, 2 `l z ` 1Jo-P�o s f �fo •v : fG.
111 I " (e4c ,- ' S cw
GO(NSTRUCTIONI 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: c/Y 3 2- Sq. Ft. of First Floor:
Cost of Construction: $ - & /, `o Oa Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CO NTACTO RR:
Name /F i cC�$ f%fin
"
Name: -3ay-e— C rave
Address: 7S S'i2cw �, 1'& S-Sr y - -
Company:,, ITC-. �O /9r'u5 r' C—
City:wi%u`Cq- 2. .4 Stater
Address:` O /��
City:': State: FZ
Zip Code:/r(� 7 - "' Fazr
Zip Codea .r Fax:
Phone No. 77% -`2(!� 13M
E-Mail:
Phone No `Z%6 - /,3Y &
Fill in fee simple Title Holder on next page ( if different
E-Mail OTC,. eo,,C(-{'..Pl v SW M
State or County License %
from the Owner listed above)
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.
DESIGNER/ENGINEER:
Name:
_ Not Applicable i
:_w
MORTGAGE COMPANY: _ Not Applicable
4A;me:
Address:: '
Address:
City:
Phone
State:,.v C :i ""Clty:
, State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
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 ONTTHE JOP SITE BEFORE THE FIRST INSPECTION. IF YO�% INTTEN�j O OBTAIN FINANCING, CONSULT
WITH YOURILENDEIZriDR AN ATTORNEY BEFORE RECORDING YOUR�IYO�iC6rO,F COMMENCEMENT:"
as Agent for Owner
STATE OF FL
COUNTY OF
The f ing instru nt was acknowledgee,d before me
this day of 20141 by
�r4,) Ift C �0,Ln.G),
Name of person making statement.
Personally Kn OR Produced Identification
Type of Identific �'o
Produced C,
(Signature
_-
MYCOP I
o. .i_ :Commission NmRESId2023
Signa re oT—Contractor/License Holder
ST TE OF FLORIDA
COUNTY OF
The fging instru nta acknowledged me
this dayof �0 by Name of person making statement.
Personally
Type ofldt
(Signature
OR Produced Identification
MY COMMISSION k GUMBI 7
rXPIRES: March 6. �bP0
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