HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number:
BY
St. Lucie Countv RECEIVED
Building Permit Application FEB 0 5 2019
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMITTYPE:
PROPOSED INPROVEMENT LOCATION:
Address: loo yy 4 O[4cx-.�J Vo- A/07
Property Tax ID#: ez4- o0o'I - CaDo-
Site Plan Name: lap." Ai s 1c-I!
Project Name: j4+W hbfKi
('DETAILED DESCRIPTION OF WORK:
W,Noaw i2EI Az&,A +ter — 1ov6.irv6 / .1MOALT
CONSTRUCTION INFORMATION:
Lot No.
Block No.
Additional work to be performed under this permit -check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
o�
Cost of Construction: $ ZHCX>�
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNEJt/LESSEES'
CONTRACTOR:
Name" 4044we- A4&dA4L5,X;
Name: MI&ongt
OwiN
Address: 190 BOX S?e oto
Company:-TET+SEN
A411VUAl
City: /Nlom I M State:_
Zip Code: 1 Fax:
Phone No. 3�/ 81Z-'�3Z
Address: 172z. Nw fil2unAz (fty
City: !z J Art,—
Zip Code: 3NIi y
Phone No 617, • 00g(2
State: FL
Fax: /og2- 9lyy
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail M, c #WAIL
kf)Wnu/ &$e4h • "A
State or County License
6 C / fa 8t13 -7
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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: _
DESIGNER/ENGINEER: _ Not Applicable
Name: F"aioA
MORTGAGE COMPANY: _ Not Applicable
Name:
i ion
Address:
City: State:
Zip: (oDR Phone iN-33j,,�Q4_
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 y ur paying twice for
improvements to your pr %rty. A Notice of Commencement must be recorded and god on the jobsite
before the first inspeptig ou intend to obtain financing, consult wit nd�tt torney before
commerrcine walk aoff rne.vour Notice of Commencement.
Signature
as Agent
Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �c7j .0 l�C1F COUNTY OF vr'% UC/E
The forgoing instrument was acknowledged before me The far of g instrument was acknowledged before me
thisZ�dayof f�?? .20Z by thisMof 25Z6 _.2t by
/-/, � 4L- .0 /GCJ/Y� /(-I/G'zC/AY�—
Name of person making statement. Name of person making statement.
Personally Known ✓ OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification. I Type of Identification
(Signature of Notary Public- State of Florida) (Signature of Notary P-t,n_
Commission No.11 'M ANNM.(OITD
oMMISSIuvYG0269714
EMU, Dacem9v7, 2022
•..?� ..•° Bon zlThu Notmy Pub& lndennBers
REVIEWS l
COUNTER REVIEW REVIEW
RECEIVED
PLETED
,•...,. ANNlit GAUMOND
l�
Commission No. ! MYCOMIA 80N0GG269714
eif EXPIRES:DecemDer7.2022
REVI W PLANS � VEGETATION
S REV EWLE MANGROVE