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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE Date: q 2-01 FOR APPLICATION TO BE ACCEPTED Permit Number: SCANNED BY RECEIVED St. Lucie County APR l'y.1019 Building Permit Applicationperm,tt; ng artm Planning and Development Services St. Line �ouent Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ✓ Residential PERMIT TYPE: AN.0gg3 Address: c5�LGu Daln-r L_I.LLl1t IT-AvtA, -lure I L, D-t-1 -r(a Property Tax ID #: 1 q 2-?' -7 oz -149 L - QC©' Lot No. 1-7 Ciro DI.., nh.. o• Block No. ( Additional work to be performed under this permit- check all that apply: _Mechanical _ Gas Tank Gas Piping _Shutters _ Electric _ Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: Sq. Ft. of First Floor: _ Cost of Construction: $ C1 O 0 1 O O Utilities: —Sewer _Septic Windows/Doors Roof Pitch Building Height: OUVNER/LESSEE'` CONTRACTOR b ��,,; I. Name U-0— Name: 7Rq aj-er OI Address: u'A?00 SCJ I Wl- L, Lome NV-6L. Company: Soy) Seswir) ho. City: F64 T (�p-me� State: RL Zip Code: c�- 94 p Fax: Phone No. �S4-605-HIM- Address: 54'1S ON a, IMCS -> M 153 City:V01-j e Stater Zip Code: c3tf0jZ5 Fax: Phone No 197-- Z Du E-Mail: �i K-SC. Nre)tb ndjSouthCocSt,CGIr Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-MailUASc),SESS4 M A @ m A I1, • Wy 1 State or County License 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. SUPPLEMENTAL GONSTR(JCTIO IEN LAW INFORMATION DESIGNER/ENGINEER: Name: _ Not Applicable MORTGAGE COMPANY: _ Name: Not Applicable Address: Address: City: Zip: Phone State: City: Zip: Phone: State: FEE SIMPLE TITLEHOLDER: Name: _ Not Applicable BONDING COMPANY: _Not Name: 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 Wd 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 SUE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WFI H YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:' Spa_ 0. J44-4 �� _ Signature of Owner/ Lessee/Contractor as Agent for Owner Sign ure of Contractor/License Holder FL!! STATE OF FL!!TA STATE OF FLORID/� COUNTY OF t. % a c: COUNTY OF Sf ti r , The for Ang instru ant was acknowledged before me this day of r ' ( 20-4by The f r Qmg instrum nt was acknowledged before me this May of J 20a by _`1AS0✓1 Sny5-AM,. ( �G5o/\ 7nSSR/In) Na a of person making statement. Name of person making statement. Personally Known - OR Produced Identification Personally Known OR Produced Identification Type of Identification "'Ix. Y?'Joseph Gomel Type of Identification ��¢Up`, " Produced _ Commission # GG16140 Produced _*b � : jOSeph GOmeZ _ = Expires- November 16, 20 of Bonded _ 1 , Commission g 661614 op' Expires: Nova thru Aaron Nota ""P ',, v� Bond mbar 16. 20 gnatur o ublic- State of Florida) (Sig t e of Nota ublic- State of Florida) mrwa Commission No. Cli16 Al d (Seal) Commission No. QG r( /L(( (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.2/7/19