HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETE
Date: �\O� \1
l\)R APPLICATION TO BE ACCEPTED
Permit Number: 19'O I
SCANNFn
BY
• J' St.LUR c®UP�� RECEIVED
Building Permit Applicat on SEP 1 4 2ols
Planning and Development Services
Building and Code Regulation Division 5T: 6d@t@ caunty, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE: Sin9�G Fao%;�. �dcHce�
PROPOSED IMPROVEMENT LOCATION:
/
Address: ` N PPls,tle-r L&. _- _ Corciinal Glades 8{Y 1
Property Tax ID#: 0143q-90:2-000L4 Lot No. 4"a5
Site Plan Name:
Project Name:
DETAILED DESCRIPTION'OF WORK:
2,512 -
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
Block No.
LMechanical _ Gas Tank _ Gas Piping _ Shutters —Windows/Doors
i(-Electric Plumbing _Sprinklers _Generator X-Roof Pitch
Total Sq. Ft of Construction: ay8 1 -1
Cost of Construction: $ All , OU';
Sq. Ft. of First Floor:
Utilities: _Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 6-V-0zo (3.�I�crs ,Zn�
Name: Siilv,
Address: S-tc S.a PS►' GkOC .
Company:_ Crv�z o
g,i,ldus� =nL,
City:' -fork State: L~L
Zip Code: 3ti953 Fax:
Phone No. 1'Z2-33L-v- 7LVs3
Address:
City: P6rk 5k.1 tict¢
Zip Code: 391153
Phone No '112- 3
State: 'FIL.
Fax:
- `hfi53
E-Mail:'t� q (vza lov o\d-0 (3, Cam^-
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail `^
rV2.0, bLA) S - C'Y\
State or County cense
CCGG 15 a N13
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.
d'A'1\5
S.UPPLEMEfNTAL,CONSTRUCTlOP N'LAW INFORMATION:
DESIGNER/ENGINEER:
Name:Ch.-i s, 6eev'S
_ Not Applicable
Wokoym ,
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: D o "aebowr
Or r.
Address:
City: Punta (,,srda.
Zip: 41?Phone
State: L.
9yf-cs28-o(.35
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not 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 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 ure of Owner/ Lesse' / ontracto s Agent for Owner
Sign ure of Contractor ' ense Hc&r
STATE OF FLORIJJ��,pp
STATE OF FLORIDA
COUNTY OF 3t. t �C;l e_
COUNTY OF &, Ck)Qik -
The fo ing instrumen was acknowledged before me
The f r oing instrument was acknowledged before me
this day of c20_ff by
this ay of !�&A 20 by
S �1��l�,cruI 9CC,2,c__
:T6hn A-r\+ )n" GcUzc�_
Name of person making nt.
Name of person making stateme t.
/stat
Personally Known V OR Produced Identification
Personally Known V._� OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Q
(Signature f Notary Public -St of Florida j
(Signature of rGotary Public -State of FI ri a)
Rr
FF
Commission No. Vy (SeaRNGIE FINLEY
C emission No.
MYCOMMISSION a F904
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MA INLEY
R
COMMIS 1
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ember 17,:ot9e
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DATE
RECEIVED
DATE
COMPLETED
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