HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
���� SCANNED Permit Number: --0=\TA
BY ri o Zi4e. p1G'n
St. LucieCnirnty q.d Lt�4 n+,h-y
-' nec-deel per
—i — -- Building Permit Application
Planning and Development Services 17d I
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
CO\ 5
PROPOSED IMPROVEMENT LO TION:
Address: o I ° 2 S�vJ—s-hper,4IJ 1>72W/I )3g4"
Property Tax ID #:
Site Plan Name: fSU.'Y- d vim-Q0Dd
Project Name: /.1"i(-_AfJT'IS GL,IL-!)iriCj ,A
4-
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: C2
�n
Cost of Construction: $ 2-FSD ^ Utilitie
Address: j010a.-%dT0- ccz-Ad 'ALz
City: Tlz4ysxd OP-A-C1i , f=L State:
Zip Code: 3 J%� Fax:
Phone No. (71 a) X X 9 -- 90
E-Mail: ZY717 —.91?-`OlcIcl
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Lot No.
Block No.
_Shutters _Windows/Doors
_Generator _IRoof Pitch
Sq. Ft. bf First Floor:
s: -Sewer Septic Building Height:
Address:&&-& i W S1 'W00 (:iL-Vil S.?L7'F- 14D
City: pTLL W DO 1. FL , 3-;'-& 02 ( State:-r-�-
Zip Code: Fax:
Phone No 02?✓ -0070
E-Mail (g F YL/ LD/N� Cj7/�
State or County License SJ2J77; 64C OV o5Z
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.
OCT 21 2019
Permitting Department
St. Lucie County, FL
E N:
MORTGAGE COMPANY: _ Not Applicable
Name:
SUPPLEMENTAL CON UCTION I l
DESIGNER/ENGINEER: Not Applicable
Name: pAVIS+ CL04-7-0 f4'I'VNi/L.r' G
Address: o �i o kV Ar-' S0 1 fr; %
Address:
;fJ"
City: -S s� 113 _ L State:
Zip:3ol -1 Phone
City:
Zip:
State:
Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: Stu!&
BONDING COMpA
Name: fJ
_Not 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 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. 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 INSPECTIO rr IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU11 NOTIC"F COMMENCEMENT:'
Sig Lure of Owner/ Les ee/C ntractor a for Owner
Signature race License Holder
STATE OF FLORIDA
STAT O FLORIDA /7 "
COUNTY OF PL911G
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this % day of Oe jZi fi jr , 20f I by
this —7 day of (')C ft 1 4— . 20LE by
Name of person making sea ent.
Name of person making statement.
Persona ly o OR Produced ldentCifi`c6at�iicin
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
iti L. Jones
)iq1 1Na c,
(Signature N&C#
(Signature of Nota ublic-Sta of Fl�rit�a�
�L
S STATE OF FLORIDA
Commission No. x GG2{fBBSI)
INCo
,� o NOTARY P
Commission No. o
I 19"0 Expires 8/13/2022
ATE OF DA
• Comm# GG248031
CE 19
Expires 8/13/
22
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
I�I2
RECEIVED
L
DATE
COMPLETED
Rev. 2///19 - v '- 6