HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMP_=._D FOR APPLICATION TO BE ACCEPTED
Date: d J > -/ PermitNur
SCANNED
r It J ._ BY
o:y St. Lucie County �C
Building Per et Appl cotion OCT 12019
Planning and Development Services ermltting Department
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)-462=1553-Fax: (772) 462-1578 Commercial Residential Xx-4
PERMITTYPE: rM,ly le>zsro(e.n-i10.JL
Address: 9 701ff
Property Tax ID #: _
Jl n
- 50� -
00� I - 0 (� D - U Lot No. -7 f
Site Plan Name:
lo��
PA'-rn
/3 e C- E Z 6
�'/y /j Block No.
Project Name:
M 6 /2. Ai
, n/ of's r a-c-
pl-�.SE ( �
C.
3 " ro-o-r IZ- P mil- .-
Additional work to be performed under this permit- check all that apply:
I Mechanical — Gas Tank — Gas Piping ✓ Shutters ✓Windows/Doors
Electric ✓Plumbing —Sprinklers — Generator ✓ Roof 6//;
— Pitch
Total Sq. Ft of Construction: Z/lp a--Sq. Ft. of First Flov- l 5 Coo
Cost of Construction: $ 103 (e0 O . Utilities: V/Sewer ; .. -eptic Building Height: 17 ' 16 H
„OWNER
l SSEE
A
CONTRA CT OR
Name
Eompany: }2er\,.r
�R•�, 1�Je -S Ll
Address:J�17�o2 � � eFacd &2a 91v9 S iii /
City: J�f�/L N h State: F _
Address:37.Zs 5
&_14 N04 &V. �o �c to
Zip Code:�49 %, Fax: 77 -- / 9A. �%/ S5�
City: !fir n h {
State:' FL
Phone No. -IT), 1�elA- 7ff0n
Zip Coder-_ (o
Fax: `/7,L 6'1 q c�/,
E-Mail: R14oti6A/)_6WE_ e PF,rRnl7mne5 %M
Phone No �J-
_77-�
%,'� 9,2,
Fill in fee simple Title Holder on next page (if different
E-Mail L14 JOA R-6 W E, (c P_,C J /W r-I 6" S. cFi
State or County License
2/3C.
from the Owner listed above)
.woos .. a.vuuucuIeu1enr 15 requlrea.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required,
DESIGNER/ENGINEE : _ Not Applicable
Name: /r�iff�( a r
Address:
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
City: State:
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY:
Name:
_Not Applicable
Address:
City:
Zip: Phone:
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 OBTAN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT-"
as
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF c4 Lu cA Q, COUNTY OF Sk LU G
The forgoing Instrument was acknowledged before me
this LQday of 20 19 by
l_.I sa �tel
Name of person making statement.
Personally Known ✓ OR Produced Identification
Type of Identification
Produced
�1"tUy1G�-� p4�,P�B NDASROWE
I1 I I XVV IV7VJV
(Signature of Notary Pub ' e o
xpNes ay 19, 2021
Commission No. t`ory o� eendedjge'aoW1140tarySenkea
The forgoing instrument was acknowledged before me
this .10 day of e m 0 20_d by
G-1 �P-A-DAc4s
Name of person making statement.
Personally Known r/ OR Produced Identification
Type of Identification
Produced
SignatUre of Notary Public- S i b�iorid�mmisNu #sRey 10E
4656
Commission No. y c (f8 -Its May 19, 2021
E�«,pP Bmdedi1a Budget Notary ServkAa
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