HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLIGiBLE NFO MUST BE COMPLETI'
111 APPLICATION TO BE ACCEPTED
Date:91(3,1(1SCANNED
Permit Number: V%1-00.01
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BY RECEIVED
St. Lucie County
SEP 18 2019
Building Permit Applicati Dn
Planning and Development Services
ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential
PERMIT TYPE: (ec,+ri-6
PROPOSED IMPROVEMENT LOCATION: -
Address: (OD ! l
Property Tax ID #: ��� 7i� —
0 o65 0 0 - Lot No.
Site Plan Name:
Block No.
Project Name: �re rgNw��S
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DETAILED DESCRIPTION OF WORK:
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CTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters -Windows/Doors
Zectric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ O oo - Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name_ S}. L&xcce CA&*x
Name:
Address: 7 DO U/ NAg-,Q
Company: 4W M G-
f ac .
City: z 1'; Clt Q_ State
ZipCode: `L 1111 Fax: A/(Q.
Phone No. - 7'7/), - pl;«
Address: 14411 Ae
ssLer 1,t-\ -
City: -r4- P ens
Zip Code: _-�19z5a-
Phone No
State._EC__
Fax: /Or-
E-Mail: Q_ 1;44uc i Pf_O , o
Fill in fee simple Title Holder on next page (if differ-
from the Owner listed above)
E-Mail /( W Me 1114
State or County License
67 9y
It value otconstruction is S2 00 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.
SUPPL[MENTAL CONSTRUCTIOI! FN LAW INFORMATION:
UCJ1%JNtK1tN%311VCCK: _ INOL Appllcame MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDMIT: 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. Lude 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."
Signa LesseeJ�as_Agent o er
nat tra /License Holder
ATE OF FLORIDA ��II
STATE OF FLORIDA 11
COUNTY OF
COUNTY OF C-L Inc r
The forgW'ng instrumept was ack owledged before me
this � day of Je��e�,c�20-4 by
The forgo'ng instru nt was acknowledged before me
this l day of 20K by
Name of person making statement.
Name of person making statement.
Personally Known Produced I
Personally Known 1/ OR Produced Identificat'o
—CZOR cyJio
Type of Identification yp
Type of Identification
;s• o..
Produced ='
Pro used
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nY.. e
(SigRihiture of NotaryPublic- State of Florida) s ? 90
(Sign Lure of Notary P blic-State of Florida
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