HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: G -3-2-Q •,2 l�4 _ Permit Number:
SCANNED
s ten- BY RECEIVED.. _
® St. Lucie Count
Building hermit Application MAR 2 5 2019
Planning and Development Services 5T. Lucie County, Permitting.
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Commercial X Residential
Phone: (772) 462-1553 Fax: (772) 462-1578
PERM IT TYPE: Ter)aAv 1 Prp nano N-b 'S,�& Fl0ot Bow
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Pf20POSED IM ROUEMENT � I t, fi> `, °" 'h S''A" �� �
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Address: N Q. Duct RoAD� lark "Pecs Fl 54415%
Property Tax ID #: 3403 - Z Lot No.
Site Plan Name: LlC' -- . acn-Tr,ek,nr Q QAA k4c*ep.cL Block No.
Project Name: �p�j�k -%t F-cid L-e4aAm2et �,:I.k�on@Tc�� rn_ evossi'
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DETAILED DESCRIPTIONrOFtWORK I ' lE Mtn "
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cam.( d u elm
Additional work to be performed under this permit- check all that apply:
C Mechanical Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
i Electric r Plumbing K Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: T<nonk 9,u,ta.Ft. of First Floor:
Cost of Construction: $ 1'70,= -R Utilities: x Sewer _ Septic Building Height:
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OW[JER/LESSEE i v 4 s v ZCOIVTRACtTO:R 4r 4 >��
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Name 7n a Pco.,pice Fovn An.lno \ oQ 1JwEr+%' S! Uej eName: gecw?Aoh N01a to
Address: I Zo 1 SE \.nA ce., Sjkmpe',k- Company: 13em! da k- (Insk'we-bon Li-e
City:.Sk.,aOr State: F I Address: 201 Sw)Ic a 1- 'Sky»eE -5t%NV- -2O7
Zip Code: 34ci9 7 Fax: (77r)40 -q 616 City: Fa. F P%ec" State: (--I
Phone No. (772) 403 4CO(P Zip Code: 34450 Fax: (79a) 2roU -3%b&
E-Mail: pN MP ptq Phone Noe77a)S7 7- S86o
Fill in fee simple fitle Holder on next page ( if different E-Mail 1 rinb, Ve G can AQtCpA5krueJk'%0v\cOv+
from the Owner listed above) State or County License eB%- iM0t' 4(a
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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DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
sa%ag 1%pal Name:
Name: Claren Qlte ht }¢cl%1Ce y 1>
Address: 6.1 A.ic}S+aa� aNSO Address:
Cwto
City: 06 90. Stater_ City: State:
Zip: R3.#8T Phone_/noN)`Zto%-,4%% Zip: Phone:
FEE SIMPLE TITLE HOLDER: x. Not Applicable
BONDING COMPANY: R 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 JOB SITE BEFORE'THE FIRSTiNSPECTION. IF YOU INTgNI1,T0 OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU ICE O COMMENCEMENT."
ASignatureoUfnert
esseeA ontractor as Agent for Owner
Signature of Contractor/License Holder
STATE:OF FLORIDA ;'
STATE OF FLO! . r ,
COUNTY OF 6i ,%c Lmcc,
COUNTY OF \ / T /i G!
The forgoing instrument was acknowledged before me
The forgoing instru�m�}ent was acknowledged before me
sr 201, by
this JV1*day of MA2c rr . 20 lot by
this ay of l"l AQ.
Murr •ro�rR.
�
me f person making statement.
Name of per on makings e0gi� '1% BRIAN GARCIA
,2 a `e, Notary Public - State of Flor1
Personally known X 6 A Id"[V85i%ff FF 940697
rsonally Known K OR Produced Identification
Type of Identification ""•"',+i•oF„ �,� My_Comm. Expires Mar ZS20
pe of Identification ._.
BoinierithrougANatio"Notary
Produced.
oduced -
\yttlu.�i ,r
e� /�, -
(S nat otary Public -State lyld di) fcr-_
i. ture of Notary Public -State of go Notary PUDlie Slate
Linda S French
I
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Commission No. BIaSI aoao=" (Seal) F
My Commission G
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ma Commission No. G man �., ) E„piras 1rz021
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