HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONa
All APPLICA LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED '
Date: S �d I \ Permit Number:
SCANNED
BY
St. Lucie Ccuiily —�
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit
Commercial
MAY 10 2019
ST. Lucie
PERMIT APPLICATION FOR: S r-R I
Address: 4-5GY7 Q- A&lW A14
Legal Description: QL)05?3S :I�SLA131> p2usu12V u 4 Plaj (0- LOT--
(L40'k- 2402.1
Property Tax ID #: cbI O - oc)o- Q> Lot No. 9
Site Plan Name: Block No.
Project Name: AQ•UA1I I5T,4
Setbacks Front Back: Right Side: $ Left Side: �. S
� 5 s YJE,�/7��/ L ,!/E li'' Go.�/�CyG�`-Tort/ , .I�• � � D,ut�f-/S � �/�//!'oovs
2 C>9� G4��?6c t �G/4fZ
--Aechanical _Gas Tank _Gas Piping _Shutters
,,'flectHc ✓Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: , 7%�' Sq. Ft. of first Floor.
Cost of Construction:$ �00.0 Utilities. _Sewer _Septic
Windows/Doors
Roof L1 �L Pitch
Building Height:—g
NameVEiJ6llArv!?t7Ml�t�i(LAYIDUliI�C==fl\la
TOLOD0
+Address:iODtAG(�IZ �(• r e7'
'Cmri an ^ y42f2'�'@F�SfnUeTloN
LLB
City: MijAM1I State: �))L-
Zip Code: Fax:
Phone No. YYPV
Address: i3 O&fi ;� 46 6r
City:--- 1 ,-t.•... State: FL
Zip Code: 331}`� Fax:
Phone No 5-8re-b4+-38S5
E-Mail: tlOe `1=6A(aSXOVMo,- ,601L1
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail VORi6L A�ar7 SiOVlF4oMCS . CF7yr�
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
....
XY. {WE
SUPPLE_MENTAL•`CON�q
:£iFV
CTION`LIEN`L'AW
INF.ORMATIQN
J'
R".
`
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
of Applicable
Name: WOO AA)D Atg3
/lyFS
Name:
Address:OO2DY�—OVIAt � S✓fr4e'l
Address:
City: V617,0 OFFA?. '•-
State: _ii
City:
State:
Zip: 3rZ96n Phone 772
—S69—SToS-
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
_
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 on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The forgq. instrument was acknowledged before me
this-' -day of 2011 by
(Name of person acknowledging
e
(Signature of Notary Public- State of Florida )
Known OR
Type of
GTZ21�2 j
; r•'1
Commission
No
,
REVIEWS
FRONT
ZONING
COUNTER
REVIEW
DATE
RECEIVED
D IC
ARIEL MORA
digtary Public - State of Fir
Commission # GG 2219i
My Comm. Expires May 31,
Signature of Contractof/License Holder
STATE OF FLORIPA COUNTY OF Q2a n
�
The forg�o,�.n9 instrument was acknowledged before me
thisKayof20±1 by
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known � PuOR Produced Identification
Type of Identification
ARIEL MORA
GG ZZ I, Notary Notary Public - State (
No. `�, al) Commission # GG 2
1 •:(fo My Comm. Exobes May
S REVIEW R I REV EW I V E EWON I S REVIEW
I M REVIEW