HomeMy WebLinkAboutBUILDING PERMIT APPLICATION4`-
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �V -2t - l ok Permit Numb r• D�
SCANNED
BY
St. Lucie County OCT 2 1 2019
Building Permit Appli Ion
Planning and Development Services Permitting 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
PERMITTYPE: S/;- AFA��LTe�2��
R OSEp MPRDUEMENT LOGA IO
Address:
Property.Tax ID #: Lot No.
Site Plan Name: S1011O Block No.
Project Name: so-�
AILED 13 7 RIPT ON 0 WORK:
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L � o-
a. , L C" , l g I t� 411 L S fr^ . O� 4lam.
c,,- l a. '6, 12' u :JR- Aorcn, q 111& r< 0 30co-es,
rNC -Mt h9VA-r-or Aa t&luG
G STR !0��NjllNkQRM ION:
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: Sq. Ft. of First Floor:
Cost of Construction: $ Z500 , O a Utilities: -Sewer _Septic Building Height:
OW N ERjLESSEE:
FO N Mi UCTOR'
Name
Name: 3c;A(2 Cbe Q_
Address: 2921 Qanno_ �.�
Company: -1°PC CcAcwte-eLs LLL
City: �f nsir�,' Stater
Zip Code: '. Fax:
Phone No. 2-17 2yt/ - TY1 q
Address: Z>) 190 , _CT90,dr�e, -
City: State:JL
Zip Code: '3 K1t$'7 Fax:
E-Mail: /?oi --
Phone No772- 216 � 13 L% 1,
Fill in fee simple Title Holder on next page (if different
E-Mail ZITe- a Con(.AP- t o Ddv S aof. Coo^ -
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.
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 O ITE BEFORE THE FIRST INSPECTION. IF YOU [NIT OBTAIN FINANCING, CONSULT
WITH YOUR LE N ATTORNEY BEFORE RECORDING YOUR NOTI F MENCEMENT."
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PP � CO RU
ON
- R O
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
Signature of wn Lessee/Contractor Agent for wn
Signature of on ctor '�"�_ N�!�_�
STATE O FLORIDA
�
STATE F FLORIDA �/
COUNTY OF
COUNTY OF _9CIJy
The forgoing instrument was acknowledged before me
The forgoing instru nt was acknowledge before me
acknowledged
thiso7l day of,20�'. by
this4 Iday of C%'Yi7L"
od P lZ � C Iz-
Name of person making statement.
Name of person making statement.
Personally Knowri•� OR Produced Identification
Personally Known `/OR Produced Identification
Type of Identification
Type of Identification
Prod/u/cejd�
Produced'
(Signature of Not ••
'( s�olunvcgip op n � 1 apuo9
(Signature of Not Public- State of Florida )
Commission No. Ei0Z "9 WlaW :832(I„dX3 _aaowi.,3,•C:
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
ANGROVE
COUNTER
REVIEW
REVIE
REVIEW
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DATE
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COMPLETED