HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLEINFOMUST BE COMr"L-r i ED FOR APPLICATION TO BE ACCEPTED
Date: _ I _ CANNED Permit Number
BY
St. Lucie County RECEIVE®
- -"- - - Building Permit Application JUL 17 2019
Planning and Development Services Permitting Department
Building and Code Regulation Division
2300 Virginia Avenue, Fort -Pierce FL34982 St. Lucie County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Re—S en Ia
PERMIT TYPE: en � �7---�• ,�,i
,,:PROPOSED IIVIP,ROVEmV N—TLOCATION ". t` a 4 a`r•,r r
Address: 1U50 S. b um Dnyt lencdn k.6VA) F-(, Tg5-)
Property Tax ID #: ti 5 D 2 -(DID J 000 -boo -to Lot No.
Site Plan Name: Block No.
Project Name: LDMbr room l2pm)JCItionC — I90uJ
,�C,q TRUCTION'*Nr0kMATION ,. tIz `..
, ,,_�-
Additipnal work to be performed under this permit- check all that apply:
7_Mechanical _ Gas Tank _ Gas Piping _ Shutters -Windows/Doors
V Electric ✓ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ ª, o0D
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
Name
Name:
Address: JU50 S. n(LUh Or.
Company:
City: a5 C.rl !a( (,1(ih State: M
Zip Code: Fax:
Phone No. (112 27 q — qU qlp
Address: I D9 15 S. otean
Drive -
City: J-M& n Bea6h State:
Zip Code: -% Fax:
Phone No(-7-72) 23'1- 73y8'
E-Mail: Qrlfl(f.SS(nnCII) @ 131'
-
Fill in fee simper
le Title Holder on next page ( if different
from the Owner listed above)
E-Mail i I e f
r K B i 1.
State or County License Z
iT vaiue or construction is 5250o 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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DESIGNER ENGINEER:
Name:
_ Not Applicable
'Q&,ruci.
MORTGAGE COMPANY:
Name: Jusen Thier/
_ Not Applicable
Address:
Address:
City: r ;
Zip: 33 te9 Phone
_
State: F�/
City: Jens<n Reach
Zip: Phone:
_State:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
Address: 10875 S. Ocean Dnve
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 o`this requested permit, I do hereby agree that I will, in all respects, perform the work
io 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, wails, signs, screen rooms and accessory uses to another non-residential use
WARNING 7'D OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your pro erty. A Notice of Commencement must be recorded and posted on the jobsite
before the first insp rPf you intend thtain financing, consult with lender or an attorney before
commencing=wor ON-ecordinevourAn lEeofCommencement.
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_
' atur f Owner/ Les
Q Contractor as Agent for Owner^-
Si natu . Of C a /License Holder
STATE OF FLORIDA
I STATE OF FLORIDA
COUNTY OFs«ade
I COUNTY OF St _
The fo g 'ng instr t was acknowledge afore me
thisdayof
The fur,�oing instr t was acknowledge More me
this.��".dayof�� 20by
//�by
^
_
, i1
JusLn Thierj
Name of er
n making t tement
Name of person making statement
Personally Known
OR 6,lrodtgr�ed !denjl�.l;(Pip9R�
Personally Known. x OR Produced Identif:cation
Type of Identification
MY CAkMIAAI!)!d B FF Qpatail
_
Type. of Identification
Produced Diners' nse
+ * E)(piijE8:Jtly20�2019
Produced a°t%Y%:°� IMCWRRAAZ
m� 6ondedThu 9V4p4t N01Y Ben!oea
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EXf'IREA:JuIyeA,2J9.
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(Sig ature of otary
I!c- ate of F rida) :
i
i (Sign ee of ota Public- State of orida )
I
Commission No.
(Seai)
Co mission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17