HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPL'zr�D FOR APPLICATION TO BE ACCEPTED
Date: �J� a� Permit Number:
SCANNED
BY
r St. Lucie County
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Building Permit Applica ionk��j�
Planning and Development Services "NfAY'28 ;'�'"3
Building and Code Regulation DivisionT! L6�ibi1n'tya'pefrl�Niie,
2300 Virginia Avenue, Fort Pierce FL 34982 ----- -
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial_ Residential
PERMIT TYPE:
shd-i ffJ 0 10.$5 Oars
IMIPROUENIENT LOCATION :,' •. ,�' -,r_ �
�PROP05EED • ; 3�
n
Address: /5-bb S• �CPlA it A� LiOL� h FL 3q95q
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Property Tax ID #: g50a - (p 69- OD 30 -D OO —d Lot No.
Site Plan Name: Block No.
Project Name:
sDETAILED•DE5 RIP.TION F WO K:
Ul
r5 i LICE,
—�� SlidiNn �i1•as5 ol.aar5
CONS�RUCTIO;N INFORMATION:, •, t ,
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 53A . Utilities: —Sewer _Septic Building Height:
OWNE4R/L•ESSEE '' ;'
CONTRACTOR:
�.. ,
Name 55i(A 41C— rest
Name: fft l iCi
„Address:�UO .5•_t7CCC,- 1 VX-, I401G
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-Company: N.0LfL)r" •,r1OUIr T-Ae-,
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City-,, ., CC�11% State:
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Zip`Gode^-3L{�52% : ,` :Fax: '
eCit`y:;'>d9it Stater
one -No.^•./ 6>-3%g-!q/?$ jK.,._^Zip'Code��i'g9!i
; Fax•7-IA-33N'16gS8Mail:
Phone No`77a— 33`I'1b1)r
in fee simple Title Holder on next page ( if different
L
E-Maik)( f1t' k �% (JQ� UfGtJ TIUL� 1r yl�+
State or County License_ / 3115101 iv 3
rn 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.
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MORTGAGE COMPANY _ Not Applicable
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DESIGNER/ENGINEER: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone
City: '' State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
EEHEEEEE
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do'the'work an"in stallation 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
POS�E\D\ 0NJHE.%AOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH 'YOUR LEINDE OR AN'ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENC ENT."
Sig ature of ontractor/License Holder
Signa ure of caner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF • Lucie
STATE OF FLORIDA
COUNTY OF � Lucie.
The forgoing instruglent was acknowledged before me
this A 20Aq by
The forgoing instrywent was acknowledged before me
thisday of' f � b t20H by
�d/a�y�ofpJF6b
rc_ �." 1 V b (I I Li
3aXtP,f' �/1` I I f G.l
Name of person making statement.
Name of person making statement.
Personally Known )� OR Produced Identification
Type of Identification
Personally Known X OR Produced Identification
Type of Identification
Produced
Produced
lmur Tl
(Signature o aryPublic- St
7� . ��✓��_®®®®®®w, Notary Public State of Florid
Commission Noo7C3 5 5' • , �Sgffo Jayne Hall
@ f�Commtasion GG 20756
qw M1y. Eepires 04/1.512022
66'5
nature of Notary Public-
Notary Public State of Florida
Co mission NcP0758 5 �jpeyne Hall
My (gyp awon GG 207565
a E„ppea "1512022
REVIEWS
FRONT ZONING
COUNTER REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION SEATURTLE
REVIEW REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.