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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 5-2-19YI All APPLICABLE INFO MUST BE COivirLETED FOR APPLICATION TO BE ACCEPTdU Planning and Development Services /,��� SCABNNEEFermit Number: �' St. Lucie County RECEIVED Building Permit Applicatior MAY 0 2 2019 ST. Lucie County, Permitting Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT TYPE: PROPOSED INPR©VEMENT LOC T10N: Address: Property Site Plan Name: Project Name: Commercial v Residential Additional work to be performed under this permit -check all that apply: _Mechanical ✓Electric _ Gas Tank v Plumbing _ Gas Piping V Sprinklers Block No. _Shutters —Windows/Doors _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: >,5oo Cost of Construction: $ - A50) Utilities: Sewer _ Septic Building Height: .2v OWNS LESSEE: GONTRAGTOR: Name-oie 0 c - oe L.l:Ncr5 Name: •yu� WDJbCl- Address: 71-22 7 L�5 W, L', 1 Company: QL. (Zr�,�c(s:lro L1 C City: FOUL � rc. State: F Zip Code: 39' 9 Fax: Phone No. 3a) -g51- 7`l 4 7 Address: 1':6o 1i J.-o-Kt1 h.n"{ b1Uc1 City: `-pr-+ Mr State:AL Zip Code: '54-I ` WO- Fax: Phone No 7 �2- 37-I 1ti3 E-Mail: ✓=i 9h e(1„z99 P �fomoo. Car^ Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail C, L-dre5 i cCCtHpI �{no�Mail.Cot� State or County License Cf'xl9622,o 1) 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 GONSTRU Lj -N LA NEOR N04 DESIGNER/ENGINEER: _ Name: Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: Zip: Phone State: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Name: Not Applicable BONDING COMPANY: _Not Applicable 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 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. I Apr Signature of wner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF �J /C. 4�� COUNTY OF The going instrum t was acknowledged efore me e The fo oing instrumt was acknowledged before me this day of 20�7by this day of 2200�Ly by I�� ! g%lkc!t Name of person making statement. Name of person making statement. Personally Known OR Produced Identification 1/ Personally Known OR Produced Identification Type of (dent 'cation ��— Type of Identific 'on Produced I LAAA X, 10 Produced AA z (Signature of N (Signature of Notary Pub. - a p,,o at R N S. NIEI-SEN ' KAREN S. NIELSEN ACPUG, ;io State of Florida -Notary Public Commission NO: n,, a� :State of r-IoridVA ry Public Pnission 4T �iY207484 Commission No. = *° Com�g pn R GG 207484 ��riS "` Mission rn Commission Expires sac` Y P My orr, Expires C June 12, 2022 June 72 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE - COMPLETED ev. i All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 1 C( Building Permit Applica ion Planning and Development Services Building and Code Regulation Division ST. Lucie County, Permitting 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT TYPE: Address: / I Property Tax ID #: Site Plan Name: Project Name: 3 �-i 2 2 Additional work to be performed under this permit- check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters *Electric 4lumbing _Sprinklers _Generator Total Sq. Ft of Construction: �vy Sq. Ft. of First Floor: Cost of Construction: $ .2 Utilities: _&'Sewer _Septic Lot No. Block No. W i ndows/Doors _Roof Pitch -1:3v Building Height: %lam OWNER�hI_E55EE: GUNTR CgTOR. Name- _ 7-L-15 I�tvt_,ac P�f C .+ten tJ Name: r 4-C-ti Mt"1 4-- Address:- 3 S (}w ( Company: CAa, .,z v-uz-4_ L (&C- City: Rss'fy"-r"i Zip Code: ''� t ( 1 5 b Fax: Phone No. 3-2-( - � I - 7 State: r-f Lt 7 Address: (2(t-m F Cr16t 4crL-� City: ( S�v-_e Q Stater Zip Code: Z Ltg! Fax: Phone No ( r w'�2 - �-q-to E-Mail: 9;�'i S L� G Gov • Fill in fee simple Title Holde on next page ( if different from the Owner listed above) E-Mail State or County License C4 1 s!'lp I 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 CONSTRUC-TION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name:: BONDING COMPANY: _Not Applicable Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do t_ he 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, l 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 FLORIDA COUNTY OF S-V . La c t -C COUNTY OF S �- %-oa Ok The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this _\_4 day of 54nm , 20 �t by this %6 day of So. 2C� , 20�d by yP ,\bA4L'N V•^R \-)'O`1\ V,cv`Ae yN VH<\�-OV�j . 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 Identification Produced �"V .� �_ Produced f L Q L •(Signature of Notary Public- State of Florida) (Signature of Notary blic-, Commission No. V.�,aa-a.da3 -(Seal) '- DEA%. it U'ula :Commission No ,,,.7.d MtdtSSHGatr}f) 2o4n - _ 5h' 'ptt@0� :a• ;r: FJtP1RESN �ry pu66cU.�e^ 029 � ded'RtN •.,e�d REVIEWS FRON coMt 4NIo k15SX011 ' ii6€�FF}' - LANS VEG SEA TURTLE MANGROVE COUN s Pt IEVd N REVIEW REVIEW REVIEW . REVIEW DATE RECEIVED DATE COMPLETED HeV. Z///1`1