HomeMy WebLinkAboutBUILDING PERMIT APPLICATION1 �
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11,a 1 1 �� SCANNED Permit Number: 1� 11 " d Sl
BY
St. Lucie County RECEIVED
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application NOV 2 7 2019
ST. Lucie County, Permitting
PERMIT TYPE:
P KQP.'OS E[I)l IMPROVEMENT LOGATION:
Commercial --X— Residential
Address: LDDc> N AIA FokTPlErrcE 'i FZ 3u9Ug
Property Tax ID#: INz3 - Soy - DooD - redo - ® Lot No.
Site Plan Name: Block No.
Project Name: V13)6NS CONOOMiN1Ul�%
Additional work to be performed under this permit -check all that apply: ,r
_Mechanical Gas Tank _Gas Piping _Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: pii))" Sq. Ft. of First Floor: _
Cost of Construction: $ -�iS500 Utilities: _Sewer _Septic
Windows/Doors
_ Roof Pitch
Building Height:
OWNER/LESSEE:
G2NTRACTOR:
Name y I C-�16 011e\
Name: Gw+r < L o
Address: 400 !J �2A i_ 0N14.AD?.
Company: Mr 1` 10( 6"JVUWO
City: State: fL.
Zip Code: .13C%i N °�, ,. •. Fax: a ' ^ C
r
Phone No. .: � ��� L/��5.--Z'i�' 0�
Address`:' Uq4; '�btr 6c kd Le�yk
e
City:
Zip Code: aT r Fax:. .
�,2R D ,
Phone NoII'
State: r-t
„
E-Mail: V V it ulcv COrvtG�J-6 • ,16�
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail I%f- VkJ
lb C o Y\ 5i ruc.-4'Wn
(o )1 JY _ C n1
State or County License C(, L 1 "9
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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.
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
'of
I certify that no work or installation has commenced prior to the issbance 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:
ev. pf/
SUPPLEMENTAL GONSTRU
E} LIEN LAW
NFORMATION:
DESIGNER/ENGINEER: _Not
Name:
Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:.
Address:
City:
City:
Zip: Phone:
Zip: Phone:
Signature ner/ Lessee/Cgr'1'tract4rasrAgesnt fqj Ow T;
Signa• re of Contractor/Li se Holder
STATE OF FLORIDA !�
STA Oq A_/,
COUNTY OF
COUNTY OF /i7GY/Qi7 K!1/P.C�
The forgoing instru ent was acknowledged before me
The forgoing instrume t was acknowledged before me
thistly day of OY 62/ 20�by
this �day of IQ 20/oiby
Name of person making -statement.
Name of person making statement.
/
Personally Known I// OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produc d
Produced
( gnature of o a P b is -St to of FI rida
(Signature P I' - a e Florida )
BETH C THOMAS
Commission ?�„� o•. Notary Public-Btate(�iiida
pV�� Notary PuEkc Stele a FI� I)
Commission P n�
Commission p GG 252703
`��?'o°'n°p` My Comm. Expires Sep 26. 2022
i
My Commission GG Y2B5r5
pia Expires H/O6/2023
Bonded [hrou
h National Notary
sn.
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