HomeMy WebLinkAboutBUILDING PERMIT APPLICATION-v
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2A'A Permit Number
SCANNED
BY RECEIVED
• St. Lucie County
Building Permit Applicati n MAR o 4 2019
Planning and Development Services ST. Lvdc County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce. FL 34982 -
Phone: (772)462-1553 Fax: (772) 462-1578 Commercial x Residential
PERM IT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID#: ,ya'S"Cp\6-Od�6-6da'd, Lot No
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
I.I
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical_ —Gas Tank —Gas Piping —Shutters
cJ
Windows/Doors
— Ele nc — Plumbing._ -Sprinklers — Generator •, _ Roof 1 Pitch.-
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction- $ Z'4;, 0/70 Utilities: Sewer — Septic Building Height: -
r —
OWNER/LESSEE:
CONTRACTOR:
NamePAleAlrsA7 w 01&110IuM 1955ad- • "
Name:_ Jfe ek%
Address: V VAO
City: � ^State: AL
ll i.. Mi V t <Ni'ifiP y
Zip Code: U ��%% ..,. Fax. ram. v
Phone No.
Addressy /P� BDX"AV_6 -,
City: LiKtee�/D5 ' :' Stater
Zip Coder-?' "^ ` Fax:- �•'
Phone No Zi7oi^a7/S'— �6Y/
E-Mail:
Fill in fee simple Title Holder on next page (if.different '
from the Owner listed above)
E-Mail 57iPt/cir�Lea✓�'4r� Cey
State or County License G 6C db/O?S
If value of construction is 52500 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: ML- Aga„vE�tei�G
_
Name:
Address: ao3o 37T� vE
Address:
City: ✓gwv 6.9GE1 State: Fz-
City: State:
Zip: 34-,L960 Phone '77a s69-70S7
Zip: Phone:
FEE SINPLE TITLE HQLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name: a �"D►� /0'P4epKt0l0a1 C/o K641e. aN
Name:
Address:. O u1t rGtFk�A-k 1 51* 30o
Address:
City: rci2p /3c+5bN� FL
City:
Zip: 3a4/o2 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 CONMENCEMENT'MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUSE H=— w
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORID /. /
STATE OF FLORIDA'
���
- COUNTY OF 4-W I ✓L ,/'
COUNTY OF Slr� 4 vci-e
acknowledge
The forgoing instrument was acknowledge efore me
The forgoi g instrument was acknowledged be&ie'me
-
thisci! day of �{ jZ [un
this"ayof F�6✓�� 20� b
�eEdAtL__ RAkI34L
B Pei 7A,P
.P S "
Name of person making statement.
Name of person making statement. �✓
Personally Known V/ OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification
•1•
Type of Identification �1
Produced
Produced
( ignature of N ot.W
(Signat 1 "
�,rs/ Notary Public State of Florida
• Barbara P Kapl�rt,..,1
Commission No 1a mission 27e
NOtery Public Stele aT FlalI
Commis Shannon nag ,(Se )
1 248M
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d Expires 11114120211
1122
REVIEWS FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE MANGROVE
COUNTER
REVIEW
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REVIEW .
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DATE
COMPLETED
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