HomeMy WebLinkAboutBUILDING PERMIT APPLICATION (2)'Ali APPLICABLE INFO MUST BE COMPLEI'+;'XR APPLICATION TO BE ACCEPTED
Date: 3 11 \ Permit Number:
SCANNED
BY
� St. Lucie County RECEIVED
Building Permit Applica ion
Planning and Development services MAR U 7 2019
Building and Code Regulation Division BTU 6y€I@ t;9uflty, P@Ff Itting
2300 Virginia Avenue, Fort Pierce FL 34982 -- -
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE: L�vh w.`r\aaW6
Site Plan Name:
Project Name:
Lot No.
Block No.
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters —Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof
Total Sq. Ft of Construction:
tlof-Construction: $ �i 0601 -
Sq. Ft. of First Floor: _
Utilities: _Sewer _Septic
Building Height:
Pitch
Name (
0CUSP-
am-
UCA
Address:
7
Company: pp Ort&,
%,,rCA �LtSS F
l ✓Y'dt� I
r
CityiC4�YVl v l rS7117iipj's State _
Zip Code: /0 Fax-5&1 - 77u5 -45-64
hone No. -
AddressJ5�.sC- 5, i'V Ie!222u2rCir SV 2
City: e0yi cd-, LtCA
ipCode: �34gI. L
Phone No `T72., 3313
� State:'
Fax:-772- 335.-1Z8Z
- 72.7 Z
-Mail: cS6 /
Fill in fee simple Title Holder on next page ( if differen
from the Owner listed above)
E-Mail yV11 )<P c;r i C1t
-fo gDbC 1I66Li`41, net
ate or, oanty License
SCG l 3 1151 Z 5�f
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
ltvalue of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTIO EN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not 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 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
commencing work or recording your Notice of Commencement.
ESigp— ff . oiOc^�ner/•Lessee/Contract5f a`s-AAgent-forOwn
t5igrrature of -Con r—f a'cfof/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 5:�r•
COUNTY OF 1 LJ
The forgoing instrument was acknowledged before me
The f rgoing instrument was acknowledged before me
thisl day of 41�tl.'O 20_ by
this_ dayof 'i+Ngf 20\ by
"\L r,e,,$\
\ SJt,�-�a
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identif on
Produced ��—
Produced �l—
(Signatu� • .�{iy•�....: State
'3•n: S�:f I GNENS 1
(Signature of No
GIVENS
pEANNAMARIE
Commission No. 7MMISSIoS�G 022023
• •v= MYCOMMISSION#GG 022023
da- K
_
• - RES: Dece ber .2020
Commission No PIRES:D e�r>ai�, 2020 rr
•'o>
••',e roP bonded Thu Notary Publio Underwriter
or ed'Dw Notay public Undenudfers
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev.y/2b/lx