HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE (t , -1PLETED FOR APPLICATION TO BE ACCEF•. _- I(�
Date: Permit Number: Alo-ol5u
SCANNED RECEIVED
BY
s
St. Lucie County nr.T 07 1Q19
Perting DepartmentBuildin Permit Application St. Lucie County
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 Residential
PERMITTYPE:
PROPOSED IMPROVEMENT OCA ION:
Address: 16D6 S Dc�c 6(v "T& g ' —&
Property Tax ID #: Y7 0a d a0 Dog Od D� Lot No.
Site Plan Name: Czf Fr r 90 Block No.
DD ,
Project Name: Jrj l
D AILED DESCRIPTION OF WORK;
0
1
I
CON- TRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters. _Windows/Doors
XElectric Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 1, 000, Sq. Ft. of First Floor:
Cost of Construction: $ 15 ow, _r Utilities: -Sewer _Septic Building Height:
OWNER/LESSEE-' I&Q11 RACTOR;
Name G t` k rf1 a e: OK lk L
Address: V9 SW r1 ✓ 4 Loy- CompAir weece
City: V > A, State: _ Address: Sd PO It f'1 I EJ
Zip Code: 309y Fax: City: Ps L State:-f-6-
Phone No. Zip Code: -M1-Z Fax:
E-Mail: Phone No - -b 2 6 %f005
Fill in fee simple Title Holder on next page ( if different E-Mail DI&OCs 0- Woe. wdwy-ed eJ c ( /_o2m
from the Owner listed above) State or County License 54 90029.20
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.
LN G•
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDAVIT: 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 avid 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 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:'
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Signature of er/ es e/C tra s Age t for Owner
Signatu of C nt c r// 'cen5 _ o der
STATE OF FLO A
STATE OF F ID
COUNTY OF
COUNTY
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of o i20 by
this _�J. day of CL(k . 20J3 by
0A Al ` a, "- / cg xla
/
m l/a/ / IOC�E O
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identificationy
Personally Know` - OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Si ature of Notary Publi State. of Florida)
(' ature of Notary Public-Stat of Florida )
Commission No ASHAHN,0431WRAHMING
Com i Issldfi'No. LASHANNAINGRAM-RAHMING eal)
tLAyCOMMISSION$GG275060
7 .'_ �.' bT24055fQR7FGG275060
r,`T�lea EXPIRES: December20,2022
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