HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETE; ,)R APPLICATION TO BE ACCEPTED
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Date: I rzi Permit Number. L
SCANNED
BY
St. Lucie County
RECEIVED
Building Permit Application JUL P2019
Planning and DevelopmentServices Permitting Department
Building and Code Regulation Division St. Lucie county
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
I PERMIT TYPE: W i,4 Dad v- D>oo>;
Address:
1?0
PropertyTaxiD#: y��OL'Go/-OIS6i'-000-d Lot No.
Site Plan Name: 17511W 1 &4 Block No.
Project Name:
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: $,q0
City: ) i
_ Gas Piping
—Sprinklers
_ Shutters
—Generator
Sq. Ft. of First Floor: -
Utilities: _Sewer _Septic
CONTRACTOR:
Name: Ari
Company: 0
Stater Address: 6700 (ti
Yn!tWindows/Doors
Roof Pitch
Building Height:
91'1.•G/S
Zip Code: (4 2 3 (n `J K Fax: City: X State: a 11
PhoneNo.-+(oi R421 -Z05(9 Zip Code: 314 Fax:
E-Mail: W IL U L Phone No s L /- 6Gd - 3j0�
Fill in fee simple Tit a Holder on next page (if different E-Mail !MdA^t LADAGo�t ✓ � o>-s�
from the Owner listed above) State or County License e C e- (SQL / Sr7cf
If value of construction is $2500 or more, a RECORDED Notice of Commencement isreq
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
Name:
Address:
City: State:
Zip: ,Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
_ Not Applicable
BONDING COMPANY:
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone
_Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: AoDlication is herebv made to obtain a permit to do the work and installation as indicated..
I certify thatno work or installation has'commenced prior to the issuance of a permit.
ermit holder to build the subject structure
covenants that may restrict or prohibit such
it any restrictionswhich may apply.
In consideration of the granting of this requested permit, I do hereby agree that l 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, wails, 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."
gnature f Owner/ Lessee/Contractor as Agent for Owner
Sign w eof Contractor/License Holder
STATE FLORID n
STATE
_
Y %k/m
COUNTY OF tt�' f4XG�_
NTYOFFORIDA,
iZli/.d%. u
The forgoing inst ment was acknowledged before me
The forgoing inst ent was acknowledged before me
this I day of 2C M by
this __L day of 26 q by
.` zz-- -' L-. )'2A'n
i
Name of person making statement.
Name f personmaking statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Ideificationn f y� p.
�eV
Type of Identification
Produced YQ/AS/�� l><Y
Produced
(Signal of Notary Public- jgrida)
=? �- Commission # FF990710!%
(Signs re of Nota ublic- Florida )
JoAnn Graves
Commission No. FF 4 a ' �rps: May 20, 2020
`
Comm ssion No. F'F9 a Coon FF990710
Ex
%., o�ri , i;onded thru Aaron Notary
„nun„
�;;v'' ; Ires: May 20 2020
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