HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ����
Date: Permit Number:
SCANNED
BY RECEIVED
St. Lucie County
OCT 0 g 2019
Building Permit Applicatign
Planningand Develo %dent services ermRtlng Department
P St. Lucie P
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMITTYPE:hurricane shutters (accordion type)
PROPOSED IMPROVEMENT LOCATION:
Address: --V— Al • Z�Lrir'Z,ItTle'1111`W.�]'art'��f —.� . 1?llT1i.,♦'���i�'G[+�
nM in 11YYY1 Block No.
Project Name:
c -, CLUJ
.DETAILED DESCRIPTION OF WORK:
Zt ac6or tYi am 9 IA�l"U' r
CONSTRUCTION INFORMATION:.
Additional work to be performed under this permit -check all that apply:
_Mechanical _Gas Tank _Gas Piping xShutters
_Electric _Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor. _
Cost of Construction: $ 10 `i `l . 00 Utilities: _Sewer _Septic
-Windows/Doors
Roof Pitch
Building Height: 14T
OWNER/LESSEE:.
CONTRACTOR: -;
Name
Name: E Wsv SoS
Company E4u1 qlr
Address: N- d K MOSS
Address: q S. 7" �i
City: State: �7-
Zip Code: 54iq 5-1Fax -7 a) a ag - $� 13
Phone Nob -7:)) aaQ-o134
City: 1- 0 tt S f. (_ f.0 (it- State- L
Zip Code: S Fax: C112)965-g43t
Phone No C-3�3 1-) 3-16 - O 66
E-Mail:0(1aana i ; n0ir-Vh Q Qik. n-P7�
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail P-4ftJ5unfi
r s e�Ser�iceS.cocvi
State or County License .1? N 5 7
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.
C.
DESIG
MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Add
X Not
X Not Applicable I BONDING COMPANY:
Address:
City: City:
Zip: Phone: Zip: Phone:
x Not Applicable
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. Wde 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 COMMENCEINETIIT MAY RESULT IN YOUR PAYING
TWICE FOR I IPROVENIENITS TO YOUR PROPERTY_ A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
ON E JOB SITE BEFORE THE FWST DISPECTIOIRL IF YOU INTEND TO OBTAIN FINANCING, CONSULT
YO'WLADER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT_'
J..dyr SdSa
Si b ature of O(vner/ Lessee/Contractor as Agent for Owner
Signaturb of Contractor/License Holder
STATE OF FLORIDA 4�tt� 1,
STATE OF FLO�I
COUNTY OF �}Y• �/li1V
COUNTYOF �C .Lyc
The forgoing instrument was acknowledge efore me
The forgoing instrument was acknowledged before me
thisday of by
thisl0 day ofSc��sasc�bG(L09by
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Name of person making statement.
Name of person ing statement.
Personally Known i"' OR Produced Identification
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Personally Known OR Produced Identification V
Type of Identification
Type of Identifica on
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Produced
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DATE
RECEIVED
DATE
COMPLETED
Rev. 217119