HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q
Date: SCANNED Permit Number: I -LOs• o,5pi` -
BY
St. Lucie County RECEIVED
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE: 10
Address: L `
Property Tax ID #:
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Allr, 26 2019
Building Permit Application Permitlrg Department
5t. Lucie County
Commercial ✓ Residential
Lot No.
Block No.
CONSTRUCTION INFORMATION: - 1 : •I
Additional work to be performed under this permit- check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: 'n Sq. Ft, of First Floor: _
Cost of Construction: $1,5zA .co Utilities: -Sewer —Septic
Windows/Doors
Zoof •Pitch
Building Height:
OWNERAESSEE
CONTRACTOR;
Nam \
Name: o
Address4kyn W. Vkko_AAA-
Companyn� � D
city��\_,keCCP_ State:_TL
Zip Code:, _L&A_ Fax':
Phone No 7 (p%- C W D
Address:o&tl_rW T2SC-OCL
�c City:W1L State: tl.
Zip COde,ILVZ3 Fax:
Phone NoQ9A)LKC '9 M
E-Mail: K,S'?e ceK- �Y'i-E�K
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mai p;t
State or County License
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.
S.UPPLEMENTALC,O,NSTRh QN 'LIEN LAWJNFORMAT(ON .. _
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Gk,./-&c 0 � Name:
Address:_np c, f_I p/��� R I , , �{ Address:
City: State: AlCity: State:
Zip: 3tig9ci Phone ,���- �a - N/�� Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
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 noworkwork or installation has commenced prior to the issuance of a permit.
St.
is inoconflicmt with any applicablelHome Owners Asssociationl rullesabylaws or anScovenants that malt'
prohibit such
restrictbor
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 the Florida
plans, 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 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."
Signature o wner/ Lessee/Contra for Agent for Owner Signature of Contractor/License Holder
STATE OF FLORI STATE OF FLOR��D�q //
to
COUNTY OF rc�VYt/ o COUNTY OF 1VI am% e.
I J
The forting instrurnent wa acknowledged before me The forgoing instru ent wa{ acknowledged before me
this day of ✓/ 201I by this 2 day ofAq
V •I— 204 by
Ij oCe 0 h r, I e M �
Name of person making statemlent. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produce L
I — i
U Rebeca M. Pastrana CG 1 U'
(Signature of Nx_ n� OR(Signat aootaryPu t
shun # GG065487
Expires: Feb. 7, 2021 * '= Expires: Feb.t7, 2021
Commission No. F (molded thrn Aaron Notary Commission No. BOndev mtu�AafOn Notary
m,So ry ;;,....;jF�
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW
REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.