HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr �
All APPLICABLE INFO MUST BE COMPLt i tD FOR APPLICATION 1 OBE ACCEPTED
Date: ID ' -;za . Permit Num
SCANNE� C43
. Lucie St.
ift1ding Permit Appl
Planning and DevelopmeAgt Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
ber: ) 9/ 0 ' 05_Q�_'
I.ationOCWED
T 2 2 2019
Permitting Department
St. Lucie CoVty, FL
Commercial Residential
PERMITTYPE: JVS-�W Me OOOS4tU c.>k ,v
WSJ h FP,# i1
ca.
t)SEM RovEM i F
ocAT cx> r x .K%# �MIV. r =, , m >ty 3 ;
Property Tax ID #:
Site Plan Name:
0
t.0 G /
Lot No.
Block No.
Additional work to be performed under this permit -check all that apply:
4/Mechanical _ Gas Tank _ Gas Piping Shutters �indows/Doors
-/Electric _VPlumbing _Sprinklers _Generator 4111A oof '(--Pitch
Total Sq. Ft of Construction: _ I L4$7b Sq. Ft. of First Floor: 1qY0
Cost of Construction: $ $, D on Utilities: _Sewer eptic Building Height:
Addi
City: U.A,a a elo J1 State:
Zip Code: '3 Zej- %-n Fax:
Phone No. — 00
E-Mail: S I ,,e*l 5- 1 9, ((� AA E 40t)
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Zip Code: `L9lo / Fax:
Phone No G" —
State or County
f value of construction is 52500 or more. a RECORDED Notice of Commencement is reouired
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
mPai'-v24i
,Y• „t 5^
3taw
DESIGN ER/EVqlNEER: +_
Not Applicable
MORTGAGE COMPANY:
j.,Aot Applicable
Name: O
Name:
z Address: Sal - I 7
Address:
City: L5.
State: _^
City:
State:
Zip: 9 2 4 g a Phone777,,n'9
�2,, � Q
Zip:
Phone:
FEE SIMPLETITLEALDER: _
Not Applicable
BONDING COMPANY:
of Applicable
Name: Kv, W PEvr
Name:
S
Address: /� afr 03
Address:
City: g.m.0 —
City:
Zip:32 S Cy % Phone: 7-L -
Z -
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
WIT OUR LFIJDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Iq
SiC na_u e� 6Winmes -Lessee/ ontractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORID
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instr ment� t was acknowledgedbefore me
The forgoing instrument was acknowledged before me
this` day of 20) by
this day of 20_ by
Snort sweene4
Name of person making statement. iName
of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identificati n n,
'�..b L-
Type of Identification
Produced
G
Produced
(Signature of NotW Public- State of Florida I Y
(Signature of Notary Public- State of Florida )
Commission No. Q!•"•Y"•fi11 r, AUDREY �.HUh1PHREY
COMMIS GG300817
Commission No. (Seal)
EXPIRES: March 6, 2023
OFM1
;j
ZONING r�
REVIEWS
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev.t///ly