HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE IINO
7T FFO UST BE COMPLI `-�,) FOR APPLICATION TO BE ACCEPTED
Date: �I—I SCANNED Permit Number:
BY ,
St. Lucie County
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
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Building Permit Application 4Ap
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Commercial C Residential cou0 e"r
PERMITTYPE: W�I.iD�UJS F ►�Oa� S
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, PROPOSED IMP,ROV;EMENT>LOC,,yAyTION ,
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Property Tax ID#: Ll 50d.- Wn t-0015•000-9 Lot No.
Site Plan Name: Block No.
Project Name:
I�IIIrJDDtuS F -Doot2s
Additional work to be performed under this permit —check all that apply:
_Mechanical
Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ T41 1120
Gas Piping
_ Sprinklers
_ Shutters,
_ Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
?;01%UNER/LESSEE; „.
'CoNTRACTOR
�„ =: =,E
NameA1�\! ; AlOAL- F461 HE2
Name:Janet Milici
Address:--t? ,5, &eA.] 1�.-1h 361
Company -Natural Flow, Inc.
City':3Crf5CA1 'PJGIi ••:' f State:
. f
Zip Code: 31{q 57r- 1 F.az::i
Phone:No..S3?S'g06.'•_%309 1','•Zip�Gode;349941
Address:391 NE Baker Rd..
Cify: Stuart a.
'Fax:772-344-1078
Phone N0772-344-1011
State: FL
E-Mail:l4i Sc-he r�rpae-6 r, rr. corn C bm
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Janet@Naturalflow.net
State or County License 131151263
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.
;SUPRPLEMNTAL CO,NST.AOCT,IOWLIEN'
LA N INFORMATIQfti
,
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City: State:
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: '
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 conlylict with any applicable Home Owners Assoclation.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 FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,, CONSULT
WITH Ynnp I FNnFR nR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." '
Sign ture of wner/ Lessee/Contractor as Agent for Owner
Sig ature o Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA — —
COUNTY OF ST. LUCIE
COUNTY OF ST. LUCIE
The forgoing instr menty was acknowledged before me
t IL 20JS by
this ii—. day
The foNoing instrument was acknowledged before me
this day of 09I L— 20 PR by
of fYP
Janet Wild
Janet Mild
Name of person making statement.
Name of person making statement.
Personally Known __y_ OR Produced Identification
Personally Known Z_ OR Produced Identification
Type of Identification
Type of Identification
Produced
k9
Produced
!�Signature
of N P lic- a F i
Ignature of tary Pu ' - f
,,n •o Notary Public State of Florida
4(.
fir♦ •4 Notary Public state of Florida
�F" Hall
Commission No. 207585 #' C(6 }layne Hall
My Commission GG 207585
ommission No. 207585 r Donnal$'gs4
. My Commission GG 207585
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Aja EzPues 04/15/2022
spate ' Expires 04/1512022
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Rev. 2/ //19
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