HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED fin{
Date: SCANNED Permit Number:
BY
St. Lucie County RECEIVED
Building Permit Application MAY "2 2 2019
Planning and Development Services '- rfnitdng Deparm
Building and Code Regulation Division �t. Lude count
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE:
PROPOSED (MPROVEMENTt0CATI0N:
Address: OaEahj 36y4t- J eVI.S2.l'171 e0.Ch FL
Property Tax ID M. 4 5/J "5-D/ —OD O /- 0o0 - to Lot 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: $—" &20 Utilities: _Sewer _Septic
Windows/Doors
Roof Pitch
Building Height:
U
OWNER(LESSEE: , „ 4
,.9
CONTRACTOR
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a
Name 0- EfifLi4&e
Name: Ofie,94r
/ m
Address: /D io .5 S aeDL 7 )rlL1f-
Company: SkL I i
reJiCe, ozmlpan�
City:.Ien,Sev1N A?1Cah State:fl
Zip Code: 14 74 1 Fax:
Phone No. d-41/-d09- 9(04-ar
Address: PLO 66Y-�Ub3Lo
City: Oj Tt(.-IiL State:-F-1.
Zip Code:.34 757' Fax:T7o2-�� 30a`1�
Phone No 711.2,' dW /lam/
E-Mail:m&,72 er(fi) liphdaq ouLDrQ
Fill in fee situp a Title Holder on n xt page ( if di event
from the Owner listed above)
E=Mail S ce-ghcfi 86WIA-11 elf
State or County License 909'YF
If value of construction is 52500 or more, a RECORDED Notice or Commencement is regwreu.
if value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. '
DESIG
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Address:
City:
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 holderto 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 J B SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR EN - OR AN ATTORNEY BEFORE RECORDING YOUR N0JIC COMMENCEMENT!'
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Signat re Owner Less a/Con ractor as Agent for Owner
Sigha re of Contractor/Licen Holder
STATE OF FLORIDA
STATE OF FLORIDA
MCL` 6
COUNTY OF 4a Mtn
COUNTY OF
The forgoing instrument was acknowledge before me
The f�r�gIng instrument was acknowledged efore me
20 by
this �YR d/a-y of_� 20 f by
this 7_"=day of
Name of person making statement.
Name of person making statement.
Personally Known ✓
Personally Known ✓ pLi�iGp
Type of I Jentification ' Notary Public State orFlorida
Dime K Bond
Type of Identification NotaryPublic 51AbofP19fk1e
Produced
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Produced Diane K Bond
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(Signature of Notary Public- State of Florida)
(Signature of Notary Public -State of Florida)
Commission No. (Seal)
Commission No. (Seal)
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Rev. 21//19 1 1 /