HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED p
Date: SCANNED Permit Number:
BY _RECEIVED
� St. Lucie County
-- DEC 12
Building Permit Application Permitting Department
Planning and Development Services St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ✓ Residential
Address: q ?)D 1 S6u+1c. Oceoj, J*_( 1
Legal Description: 0 A`OOY V-fsof I e Ne;R 12 s 15d 1CLh 1 9 1 IP � 1es -
1 A- I I, 5+. l U6 aLV\�-9
Property Tax ID#: Li6D2-150I-oDOD- DDr)ID Lot No.
Site Plan Name: Block No.
Project Name: Mav,C� C-tuava hw5e-
Setbacks Front Back: Right Side: Left Side:
DETA. ILED'DESCRIPTION'OF WORK: "
��lace eY,'isi;rj slide`- oy� �ucwd bDuse t);-H\-
1 ke �or 1 i ke-
CONSTRVCTION:INFORMATION:-
Additional work to e ne orme under tispermit-check
OHVAC Gas Tank ❑Gas Piping
all apply:
_ Shutters
❑ Windows/Doors
01lectric ElPlumbing
❑Sprinklers
Generator
g Roof Roof pitch
Total Sq. Ft of Construction:
S Ft. of First Floor:
Cost of Construction: $ 1. 100 ' 00
Utilities: Sewer DSeptic
Building Height:
OWNERAESSEE; n .+
CONTRACTOR:.
Name
-C Qkt� In . M
Name: Clnyishgbev Mc tbDhrt-e
Address:
r°
Company: Coylc,Dyd R(h 1 &'Yl9 Cap.
City: Jeiiis-ee) Rear State: fL
Zip Code: 34951 Fax: 1-1Z-229-99Of
Phone No. -112. - 229 - 29.3D
Address: ' 1 2 NN Plfa.SrAh f %.rove I/✓�
1.
City: Poyk St. Lucie Stag
Zip Code: 34'18(o Fax: 'i-12- G 21- "183/
Phone No.-1i�-201-8569
E-Mail: IAUr0.@ yj?_ i,e5
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail:1'nvi card n ova. @ Q MaL 1. C.orY7
State or County License: Crg G 9 s 0U2 (o
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
'SUPPLEMENTAL.CONSTRUCTION LIEN LAW INFORMATION. '
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone -
BONDING COMPANY: _Not Applicable
Address:
City: City
Zip: Phone: Zip:
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.
T�7
:e the permit holder to build the subject structure
or and covenants that may restrict or prohibit such
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 our Notice of Commencement.
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Signature of Owner/Lessee/Contractor as Agent for Owner
Signature of Contractor/LiceTise Holder
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Type of Identification
Type of Identification
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Commission No.
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''^� June 28, 2022�'•'•„«•
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•, 2G2
mission No.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17