HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number: Lana• 0o9o'
ZG BY
L} 'Jill St. Lucie County RFCF,L
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
Fd F
Building Permit Applicationps��G�90 9 911p,9a
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Commercial Residential
PROPOSED INPROVEMENNTLOCATION:
Address: 1434 3U Se (a I r�
DY + S . LLI cot Pv �ay//77
Property TaxID#:1541`i//W -5b)'3115- 5,0-9 Lot Nol y�✓aIMir)-
Site Plan Name: F:E57Unl.� * l /)/! p�IwulZ -1� Block No.1
Project Name: Fbtio (A > h I" Iw �. 46 r Qn f IVY' prb ✓f /h el) -
DETAILED DESCRIPTION OF WORK:
-VzimI Ott vemm+—
I CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit -check all that apply:
Mechanical _Gas nk _Gas Piping _Shutters
t/lec �tric _Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Constructiioo Jn: Sq. Ft. of First Floor: _
Cost of Construction: $ w gi, a`ZO U Utilities: —Sewer _Septic
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name C
I I
i1G.
Name: e
Address:_ lbb Iq W. ) 01m Sj V
Company: ffOiqde ►?S- rb
City:,S(A}ISr,(h6 State:&&-
Code: S2 5 Fax:
Phone No. 20 - (P292
Address: 35l(Zip
City:-h/G%- State:-r--C,
Zip Code: 3y 911 % Fax:
Phone No 1101/ -Z ,� 7�
E-Mail: T
L'11
1 E� ��. Ma l S fi>lGIS}. �i)�
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail vrC.oa bk
State or County License 6 3 �l
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
MORTGAGE COMPANY: Not Applicable
Name: Se�h P• cl�l!i l
_
Name:
Address: Cfb 0 G - OSC"Gbl
Address:
City: State: t1,
City: State:
Zip: " Phone '1'la' 2,97- In'1�,5
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ 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
commencingwork or recordin our Notice of Commencement.
S' ature if Owner/ Lessee/Contractor as Agent forOwner
Signature of Contractor/License Holder
T E EO FLOR _ ,
kUN
STATE OF FLORIDA
OFtG:2�% , 1/V'
COUNTY OF
The for oing instru it was acknowledged before me
The forgoing instrument was acknowledged before me
this' day of 204 by
this VIN day of t. 66 20LI by
;r r
ErT a Swe��
Name of person aking statement.
Name of person making statement.
Persona ll wn OR Produced Identification
Personally Known X —OR Produced Identification
Ty p Identifi do
Type of Identification
oduced
Produced PA% ET A. PENGE
g, N1 COMI�4SSIONNFF957132
W1REB:Fehnwy03,2020
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(Signature of Notary Public- St a of Florida
WOubStaFlorida)
Comm s o o. ��(Seal)
Commission No. � S7I 32 ( �i�e} MYcOOMNUSSS
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sr Notary Public State of Florida
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PLANS
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REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
iev.9/26/18
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