HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE NFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 00L���3
Building'Permit Application
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
PERMIT TYPE:
PROPOSED INPt01lEIIlIEl�T lt}CA'1'10N 'mss x
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Address: _ 0CDB c�cfir�c�t� ��-
Property Tax ID#: a 7 Lot No.
Site Plan Name: Block No.
Project Name:
DEVILED DESCiII�TION 01=WORK `
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GOiSTRUCTION �NEQRMItN a
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Additional work to be performed under this permit—check all that apply:
Mechanical _Gas Tank Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: $ Utilities:. _Sewer _Septic Building Height:
OWNER/LESSEECONTRACTC}Rs Ry
r
Name Name:
Address: 1111.1 Begc1. Com. Company:
City: ✓ ° _ State: ' s= �. .: ......-:.:.`:.. .._
Zip Code: Fax: State:
Phonet No.��S(a �� Zip 'l s ;:;:•... ."7"., ;y
Code• :,. -.�• �'��-�F;ax:
E-Mail: Lhk 9 6 ,Coen Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
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.
1
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 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 thepermit 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 agre6that 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 jobsite
before the first ins ion. you intend to obtain financing, consult with lender or an attorney before
commencing or w6din g your Not' Commencement.
Signa of Owner/Less ontractor as Agent for Owner Signature of Contractor/License Holder.
STATE OF FLORIDA I/ STATE OF FLORIDA
COUNTY OF lu COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument wasacknowledged before me
this da of r6h ,20/$ by this day of 20_ by
IA St,
Name of person making statement. . Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced 1:__L Produced
gn ture of Notary Publicl State of Florida) (Signature of Notary Public-State of Florida)
GRAM•RAIWING
Commission No. ?''r '•; �,U4I« ION Commission No. (Seal).
I ' ;t) 0GG 275060
1:�s'+� ti° WPM.DaiwW x20,2022
REVIEWS FRONT - ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.