HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED,
Date: 61a41\°l SCANNED Permit Number: 1IiAA
s h n�.vf BY
St. Lucie County ECEIVED
d Building Permit Applica[ion:N 2 S ?019Planning and DevelopmentServices Gaunty, Permitting
Building and Code Regulation Division - -
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial _ Residential
PERMITTYPE: S
Address:
Property Tax ID #: _ EqjLJ- In o I - ()Q SS - Uoo - 5 Lot No.
Site Plan Name:: Block No.
Project Name: N&V-k.I Me 1110f 1klavehousP- CJ)rAjQ►fX
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: $ i2 55v
Gas Piping
—Sprinklers
_Shutters —Windows/Doors
Generator _ Roof Pitch
Sq. Ft. of First Floor: AJ I R
Utilities: _Sewer _Septic Building Height:
IR/1SSEE
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NamelMarka,} Ayenwe_ Nd&yf. )u5P (pMpleY
Name:'DohQILL 14- 94E I1.0
LLI Address:(gl I a (),)d_ D*V ie
Company: -I[ q�i- S1 )
city: Nkwo l reez h State:'-
Zip Code: ?)2g(o2 Fax:
Phone No. -
Address: 2(Di5 X1,Ylo�,. U r(IUf
Ciro '�Bciu State:
Zip Code: 3ze6 S Fax: 32i-95i' Zt%lalo
Phone No 932-9
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
EWail LLYr> r11 is Qy-$- IC.yafi. (0)n
State or County License -ES 1201
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.
�C1PPL` ME IT L COh1 TEtlIC71Qh { I�t L NFOE2MAiVZY,
DESIGNER/ENGINEER: _ Not Applicable
Name:34-LWellc ay),Zu )4j Ll-C ame5 I,tle11S
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: iti53 Pr64-LtS;SUZ
Address:
City: Ov Prlb State: _
Zip: ?32'71o5 Phone L467-Y% 5
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: ZO 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 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 J B SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDT�OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as AgeR or Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLOR�pA
COUNTYOFZ�,c,n P ye4_
COUNTY OF E�`YEI/4h
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this__!�__dayof 20A by
this_�"tdayof Son£. 20A by
—V_ VF31a_
nI APA a. Rtdk(
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known,V_OR Produced Identification
Type of Identification
Type of Identification - - -
Produced d7�� � `�.;C?N Se
Produced
^
II
;ignalture
ak KATIE HART
of 1\16tary Public- State lorida)
(Signature of Notary Public- ♦ a t1'
Commission # GG 0422
Commission No.c_;�1( 6-,,, sHM#I1 DEANNE GRIF
I mission No. 1 ?wn jA�_y�� lgraa0hflINElNlreonalNanry u
11d
=State of Florida -Notary Putlic
-
. .Commission a GG 119945
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Rev. 2///19 V 11 /