HomeMy WebLinkAboutBUILDING PERMIT APPLICATION,7-1-
All APPLICABLE INFO MUST BE COMPLEI Cu rOR APPLICATION TO BE ACCEPTED --�
Date: '/ / 2-•e- I9 Permit Number:
SCAN "
$Y RECEIVED
• St. Luci c
----� -- Building Permit Appol R 2 2 2919
Planning and Development Services .
Building and Code Regulation Division ST. Lucie Coun_ty_Perrfll4lno
2300 Virginia Avenue, Fort Pierce FL 34982 l
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Y Residential
PERMITTYPE: COm �u,1
PROPOSED IMPROUEME-NT LOCATION:
Address: qD H
Property Tax ID#: 2- 3H- 643- o0o Z _ o oo - `i Lot No.
Site Plan Name: Block No.
Project Name: Mc•,., �n�C�o<.rt
DETAILED DESGRIPTION RF LWORK:
Na r - 4.,Foe r,f FF'ee e 6s Lkb»
, ,
4frC /, �' ...��f7 r',C� 5./� �6a�/d,� O o %L7l
r)a�
CONSTRUCTION INFORMATION: / 9
Additional work to be performed under this permit- check all that apply:
v Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors
V Electric �? Plumbing _Sprinklers _Generator Roof, y art Pitch
Total Sq. Ft of Construction: q, g o � Sq. Ft. of First Floor: 3 8 q_3
Cost of Construction: $? Utilities: Sewer Building Height: a S - fi
—Septic
O Ci
OWNER/LESSEE:
CONTRACTOR:
Name OgJ.II Mahh Conrfr et'e r^c
Namea...Q.v�-'A Mu-- 40�-r#r
Address: +iy/3/ s'..kS.l /31i .Q--Se./<
CompDu� d. Mo,� C'o..p{ r..�}'o J-!A
City: �o,i'i�:',o'�:� State: Ft.
�, .: •: P
Zip Code: Z 9.4,L Fax:��x. 489- itoI
:...; e.;
Phone No.��i- yes=� 9'3'tr"'
Address='
City:,' I*o.`l ':P:aK,•,. t' State: K/
„ .• .::w.. r
Zip Code: ?`I9e2 Fax:"-7?'L
E-Mail:olnv:cAIQQk ,n.y
PhoneNozLl6r-lR3✓T
Fill in fee simple Title Holder on next page ( if different
E-Mail Jg • J QN o .,
State or County License C G C 1 S / SS /3
from the Owner listed above)
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.
FORMATION:
MORTGAGE COMPANY: _ Not Applicable
Name:
ST ION LIEN IN LAW
SUPPLE EN AL CONWill
DESIGN ER/ENGINEER1: _ Not Applicable
Name: fir-� h: fiQ �/ en. c _ 4. c.
Address: lto,6 D Rlftw rN 4v-
Address:
City: Four State: '(.
Zip: ?ygrp Phone `Ibo-7Trr
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: D %.v A Mu
BONDING COMPANY: Not Applicable
Name:
Address: 4 / 3 ) s' L.r I IT I I IS
Address:
City: Farf 1''0..�, Ft
City:
Zip: 3yNci Phone:»a -46 r -jq 3ir
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 FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent`for Owner
Signature of Contractor/License Holder .
STATE OF FLORIDA
STATE OF FLORID
�Cr
COUNTY
OF S�iCGGG. P
COUNTY OF
The forg,ossng instrument acknowledged before me
The forgoi g instrument was acknowledged efore me
thisoV'-day of , 20%f by
this�r3ayof�t-. / 20Iby
r
,.4
/
�evsfi �L /%i Ccn n
MI/I
�QI/✓ G-n 0
Name of person making statement.
Name of person making statement.
Personally Known X OR Produced Identification
Personally, Known OR Produced Identification
T of Identification Produced
Type of Identification
ced
Notary lic- State Florida
(Signatur of )
Commission No.
ttt�7 MY CoMY Cod`
ColmmissionNoota��\oNn mFO�b�G1�88t22
etuyPublEBtate-ofXlorlda
Commission R GG 237980
MY Comm. Expires Jul 18, 2022
"" Band through National Notary Assn.
_i
' ` dndad Mroudh National Notary Assn,
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Rev 2/7/19