HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 • I q q e,;� _, SCANNED Permit Number:
l�BY
I
•
" St. Lucie County RECEIVED
Building Permit Application OCT 0 12019
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 3*14 ''�LncSu6�l'ICPI ✓�3/' � v
Property Tax ID It: _,2 Q- ✓'CO I - co Z J'- Oogn 7 Lot No. S
Site Plan Name: Wd /la %u� r'17-=;a �-b9d-7 G,f/LG 1 / I Block No. .3
Project Name:_ k/a8ge7 �r.I.S �4%7t/cz,T!?3,''! A76rn�^ 61r}', T'o miM0 r t5,e7e Pfar7
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters ✓Windows/Doors
✓Electric w'Oluombiing ZSprinklers _Generator _✓Roof 1r/Z Pitch
Total Sq. Ft of Construction: /'TES Sq. Ft. of First Floor:
/
Cost of Construction: $ Utilities: _Sewer ✓Septic Building Height: /6 _
.5W4N Geer -77N
OWNER/LESSEE: y<
CONTRACTOR:
Name Marvef5
Name: e
Address: ,64/4 _; r� g�
Company: L.LS Qg 0
City:_ N. jqBrFGG State:,/
Zip Code: '.VR40 6 Fax: 77Z- `f,(-7 gnf j
Phone No.777_!&7-�0/1
Address: $/moo /ni5 C'r
City: 15 �A/-& State:
Zip Code: / Fax:
Phone No Z - 2A5"/Q6'5
E-Mail: 4
Fill in fee simple T tle Holder on next page (if different"
from the Owner listed above)
E-Mail
State or County License G-4 G cz-2 7 q /�
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.
Name: /I'15V i5mli/ner°r/P7Gf
Address: ig� 2 f/� ,51.
City: State: it L
Zip: 3Z_Jr n Phone -4035
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Address:
Zip:
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 INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR -NOTICE OF COMMENCEMENT."
i
SIpKat of Owner/ Lessee/Contractor as Agent for Owner
Signaty ntractor/License Holder
STATE OF FLORIDA
1
STATE OF FLORIDA
COUNTY OF
!ti�=Li A lF.
COUNTY OF
The forgoing instr en
was acknowledg before me
The forgoing instr en was acknowledgedMefore me
'
this � day of
20� by
thisC—L— day of 20by
Name of person making statement.
Name of person making statement.
/
Personally Known
OR Produced Identificationy/
Personally Known OR Produced Identification t/
Type of Identif'satien
Type of Identific '
Produced
Produced
Ah
n K WAA 7.045 - �...
(Signature o
i
li - State of Florida
(Signature of Not a agA •1 pp ry
•- ommissib' 9 GG 207484
Commission
"v'b'"�•
19i4 °k:
KAREN S NI -LSE N
rida-N y'hublic
@� My Commission Expires
Commission NO. June ER 22
•?
Commission # GG 207484
My Commission Ex fires
1
une 12, 2022
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Rev.2/7/19