HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE C("�°
Date: 15,19
Planning and Development Services
'ILETED FOR APPLICATION TO BE ACCEPT -
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number: 19 0S' (3
SCANNED
BY
St. Lucie County RECEIVED
Building Permit Applicati n MAR 0 5 2019
ST. Lucie County, Permitting
Commercial ✓ Residential
PERMIT TYPE:
:PROPOSED IMPROVEMENT LOCATION 1
MO
$'
- Srlt
23
Address: 1-0a S K—I,.J S n
Property Tax ID #: 'L 31 ,;--- 3 13- OQG -Q — 000/1 Lot No.
Site Plan Name: L OVI%s C-00u aq ST06ei= [off Block No.
Project Name:
Additional work to be performed under this permit- check all that apply:
Mechanical
Electric
_ Gas Tank
Total Sq. Ft of Construction:
Plumbing
Cost of Construction: $ l,3i 562 0i7
_. Gas Piping
__ Sprinklers
_Shutters
_ Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
NameLoyES TRAva sTC0<JcxjhzW Sin-m t JG
Name:06Vf A 6,EP-0AAiA-
Address:15 tU to -A S7- svrrF r%4o o
Company: GEV-FLC O 5LVC IcALL C0vn2-
City: TiJL_SA- I ot_ State: CJK
Zip Code: " 1 Lf 1 19 Fax:�73(a
Phone No. ` 129% 43 (o — 73 b
Addrrre��ss: dab pi_VJ. FL�TfaPQ4 (6 Did
City.-P012.1 er LVC 6 State:FL
Zip Code: 3 49" Fax: 77Z- 3q-0- 7
Phone No 772- 0— V
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail (A %e-P,72-I A cl� GF.eaco
T
State or County License 1 C i 3 0 03q /.i
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.
SUPPIEIIJIENTAL.CONSTf
ION"LIE1U•LAWINFORItiIIATION
DESIGNER/ENGINEER:
Name:& ¢ it ASSOG /G4RY
_ Not Applicable
&_40a 9-D 6
MORTGAGE COMPANY:
Name:
_Not Applicable
Address:79I(p.4/ BgDkhwAV
Gcr
Address:
City: Stater_
Zip: 73116 Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
of Applicable
BONDING COMPANY:
Name:
_ of Applicable
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 anti 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEJJM�D TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER40R Ay ATTORNEY BEFORE RECORDING YOUR NOTIGE,OF COMMENCEMENT "
Signature of Owner/ Lessee/Contractor Is Agent fo, Owner I Signature of
STATE OF FIL DA STATE OF FLORIDA / /^=
COUNTYOF Qle�•S{.%1e COUNTY OFPtag' -bwje
The f/ofgo�ing mstrumennt was acknowledged before me The for oing instrument was acknowledged before me
this � day of ,M.Fk>r . 20 q by this day of �•t,[4f�F�QrI , 20%C' by
Name of person making statement. Name of person making statement.
Personally Known _k_— OR Produced Identification
Type of Identification
Praduced
UA�_ "(v� -
(Signature of Notary P -
Commission No. _ • : MY COOM)ON # GG 132161
`1' • • EXPIRES: August12,2021
SY _L[
I34VAIXrJL.'1
RECEIVED
DATE
Personally Known —4-- OR Produced Identification
Type of Identification
a', GImC ,,
(Signature of Notary Public- State of Florida )
Commission No.
GG 132161
COUO TER ROEVIEW 5 REVIEWUPERVISOR I REV EW I PNSV EV EWEGETATION S REVIEW EATUR_fL�I REVIEW