HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABUEJINFO MUST BE CCIMI� ED FOR APPLICAT19N TO BE ACCEPTED
Date: liq lb I SCANNED PermitNumber: 1919�1
BY
U_;_5T1J1 Llai St. Lucie Countv
1� I AECEIVED
Building Permit
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X
PERMITTYPE:
cavonAUG 2 3 2oig
Permitting Department
�Upi County, FL
I PROPOSED) M PROVE M ENT LOCATION:
Address: ao y Ce 3V qs�—
Property Tax ID #: -3,jl0_ q9 oobs-000_2, Lot No�
Site Plan Name: Block No.
Project Name: -Ae, S+oraw�`Iaq�
DETAILED DESCRIPTION OF WORK:
'5� Fio-kc-s A Z1 s'4q 11 I'/1'a 'q d6l1to.A 'C **_qw" 0164al Lej6c�(
�Igxcyr_InCA 044(c, 4�601e'
CONSTR_'jrCT,'6'N INFORMATION:
Additional work to be perFormed under this permit -check all that apply:
—Mechanical — GasTank Gas Piping Shutters
— Electric — Plumbing Sprinklers Generator
Total Sq. Ft of Construction: 30 0 0 Sq. Ft. of First Floor: —
Cost of Construction: $ -.5-0 000-'�' Utilities: —Sewer I)(- Septic
— Windows/Doors
Roof Pitch
Building Height: 2�
OWNER/LESSIEE:
CON TRACTOR'-'_
Name -1�e-!�krgc,#.
�Dpqj (qpt-k-y,
Name: (-9 rp 4-1(�-
Address: S1501 S.
1) S t4b)
company: QG Sero;c_ec, 1) C,
City: F+ VIelc-e-
ZipCode:
PhoneNo. -77?- &S'197301-
State:
Fax:
Address: 8-J4 Se V--,endall af�
City:(99--1 94 kle'4 State:YL
Zip Code: 349 g Fax:
Phone No
E-MaiI:_+0e (vq5_D ko� Aj a: CO3YN
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
I
E-Mail Qq�Ne ry i c,ersiPt 6) Qna,
State or Colunty License OibC ; ) 2,f5q4Jp I=
Q, be I 2-f:z q4 z0cl ' ' — _J
t value at construction is �;Z500 or more, a RECORDED Notice of Commencement Is required.
if value of HIVAC Is $7,500 or more, a RECORDED Notice of Commencement Is required.
'�,YPPLiME!�TAU-C�f�
0 U NEORM
AT q
DESIGN ER/ENGINEER:
Name: i C4 rn
,L Not Ap e
,,,,.p ica
vlo
SY49 ',
g',
MQRTGA GE COIMPAN)�
kW 5e -or
me: .5� NA A
Not Applicable
Ark
1,Wyol gol
Address: 1 3 os "i
—
-1
City: k-
Zip: A2_9&Q Phone_222-750-'7&,?_.2_
State: _Y/—
City: ff-41� - I
Zip: 30?= Phone: '772-'14�6-,75VQ1
State: F-f--
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
7ZNot Applicable
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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an9covenants 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 WROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTEWDHE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
LE
WIITKA LENDER OR AN ATTORNEY BEFORE RECORDING YOU"OTICE OF COMMENCEMENT."
/gniture of Owner/ Lessee/Contractor as Agent for owner
�Ignature of Contractor/License Holder
STATE OF FLORIDA I
COUNTY OF 7�� l-LLc_i: C�
STATE OF FLORIT
COUNTY( Luc-C
C
The forgoing linstruTem: was�acknowleclged before me
The forgoing instruTent was acknowledged before me
thlsZ';� dayof Au9,4:z,+ 20_d_ by
this 9a day of �( ��k 20-a by
�64eL3
'
(Oreir� E) Grg4-S
Name of person making statement.
Name of person making statement.,
Personally Known OR Produced identification
Personally Known _>___ OR Pro R. N8MN
Type of Identification
Type of Identification
IMINV My COMMISSION #F!'9753
Produced
Produced MRES: MAR 24.2020
APRIL R.6NELSON
Faw
Bonded thipough I at state Insur,
==L ------
Fa')�
Iff COMMISSION #FF975
4
39 :ON
Ar
WIRESSMAR 2
(Sign Stu re of N ota ry Pu blic- State f Pf6ifta yOnded thilDligh tat State Insul
m4 ainat6re of Notary Public -'State
.
Commission No.EEa_'2,_53aJ (Seal) APRIL R. NEELSO
-�qtnN#FF9
mission No.. 3 ea
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