HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE CONktfED FOR APPLICATION TO BE ACCEPTED •�
Date: Zt ' SCANNED Permit Number: 1%
BY
ay~- At MI e, �� � St. Lucie County
Building Permit Ap
$ F"
tion FEB 2 6 2019
Planning and Development Services Permitting Department
Building and Code Regulation Division y
St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: 1 i IIACIOUJ$ adlcL $1icliln 00Q-55 oLCor5
Address:
L
Property Tax ID #: LE511- 511P-06 5LI-000-$ Lot No.
Site Plan Name: Block No.
Project Name:
Additional work to be performed under this permit -check all that apply:
—Mechanical t l— GasTarki I Ga's'P.iping —Shutters! _Windows/Doors I
— ;
—Electric i Plumbing" -i; i.%.Sprinklers —Generator ii f ,Roof i Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 1 sIr #Iq 5
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building'Height:
QWNERrITSSE ,q ;* x'04,
k y, rstts
GQIVTR�ACTOR 4 "'PETV
Name i5
Name: cU f
Address [oSiSf'S °MCP -la.
SO`] 3
Com an Zhu:
pf y r. ,:.•_ , ,,• lo"w
R,
,city zo 17 State: r- �-
Zip 'Fax:
Phone No. ��roi�=„50,�='055I
Ad&si 1
city: JlUct%I'i' State: FL
Zip Code: -;4q 7 Fax:'GZpZy- Ib18
Phone No 0�'33 - 011
E-Mail: geyin @ AoH6 &.15. Lowr\
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail &4L,+ 4KkIi 1
ouj , ne-
State or County Licensej�
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.
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: ' _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
Zip:
OWNER/ CONTRACTOR AFFIDVIT-Application`i's hereby made to obtain a per`mit•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 Countyy 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,,,bylaw's.or angcovenants that may restrict;or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
1, - , J
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respect's;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
... r.lr... nn wN A rnoNcv Rrrnov orrnonlNG YOIm NOTICE OF COMMENCEMENT."
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J t ,� �1 i�� I 1 I' _ �1.1) _I_ 1'II/
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Sign ure of 0 ner/ Lessee/Contractor as Agent for Owner
Sign ture of ntractor/License Holder
STAT FLORIDA�
ST
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COUNTY OF 1��1�
COUNTY OF
The fo oing instr ent was acknowledged before me
The for oing instr ent was acknowledged before me
by
this day ofRJ7ru 201q by
this day of U 20-LI
YV\ 1 l i u
\o1y c_+ PY\ i l i c i
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification \
Persynally Known X OR Produced Identification
Type of Identificatiorl
Type of Identification
Produced
Produced
(Signature'ofNota -P' lic,TidaljitaryPuohcSteaofFla �
(S nature ofNotaryl li 1-St o n - , 1
r ry PUDIx: Sate of Florid
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pp �LDo�'nna pomm� GG Hall 2075e
Commission No.t�7556-i;r�a�(Sea6tr soutsr2o22
t oo - L,I OOrina!J Hall
C mission No.O�d7So� dr,(j nmluron GG 207585
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a� expires 00115@022
REVIEWS
FRONT I"
ZONING '•',SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER_
-,REVIEW ,.
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2///IV