HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q
Date: -ZS• J SCANNED Permit Number: �U3 - a U (1
_
;idyl BY VYVES
a St. Lucie County
• - MAR 0 b 2019
Building Permit Application
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 4624578 Commercial Residential
TYPE: Qq,
Address:
Property Tax ID #:
Site Plan Name:
Project Name: U
il4s
Additional work to be performed under this permit -check all that apply:
Mechanical
Electric
_ Gas Tank
Total Sq. Ft of Construction: i i
Cost of Construction. $ 1 N K iD
_ Gas Piping
_ Sprinklers
go
_ Shutters
_ Generator
Sq. Ft. of First Floor: _
Lot No.
Block No.
Windows/Doors
Roof Pitch
Utilities: —Sewer _Septic Building Height:
:IWNER/LESSEE: -. :e
CONTFtA[iOFt ,
Name n 1<tt -1
Name: Voil
Address: i goDy4ri�i �6i� � Q
Company: titIP�t�th�ZfirmAi L
_11-S
City: J�,lax+ l.�Gt 1 Stater
Zip Code: �j?jt Fax:
Phone No. Cc.li Cj154 -jii•ip gg5ll
E-Mail:k
Address: 11'eo ,
city: Stater
Zip Code: 3--1q(¢b Fax:-1L0gH!Q!4p
Phone No
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail `f'A' Lor--1
State or County License 069459
It value of construction is 525uu or more, a RECORDED Notice of commencement is required.
If value of HVAC is $7,SGO or more, a RECORDED Notice of Commencement is required.
City:
Zip:.
FEE SIMPLE TITLE HOLDER: t/Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Address:
City State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Applicable
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.
at. wg,e wun�-niaKes no represencaoon.tnat is granting a permit will authorize the permit holder to build the subject structure
which is in con ict 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 peripit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms andaccessory 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, tender or an attorney before
commencing work or recording your Notice of Commencement.
let
STATE OF FL0I19A M STATE OF FLORIDA to
COUNTY OF ��,L�k r COUNTY OF P
The_kgoing i trpMqnt was acknowledge beforeme The f oing instr ent was ac n wledg oM (mi
this day of 20 by this day of 20 by
{YF a 1 Name h� �Lieme rl � �
Name of person making statement, Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of I fixation Type of Ident' tion �/� j
Produced �t1� Produced ` t DL % 10-01aS
• "•'s Commission 1359tl3 i
Commission " Comm.E 19,20,1 r PeggyAr
Commission No. 1 NOTARY
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ondcdlhmugh National NnlaryAtsn. _
'_ STATE O
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REVIEWS
FRONT ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
EIiAN�IIOF� t
COUNTER REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
BATE
RECEIVED
DATE
COMPLETED
n.
250