HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Perm .it Number: 2s-91
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1558 Fax:(772)462-1578 Commercial Residential
PERMIT TYPE:
Address: 1 ��c „ �J ���'Cl. D irz- p4 0. J �1]Sera �P�4G�n4
PropertyTax ID#: t "sot - p -J Lot No. 1;�00
Site Plan Name: CTO (.� 00+- U: 5-T � U CLe- C Block No' G
Project Name: y+a 21I�.:r"'A. AA-re-xAr: W
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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:$ �-'93,bo Cz- Utilities: _Sewer _Septic Building Height:
Name_.LU_��e n ..�e ratiod` he.G.V Name:L orac-L5 i;z YY%D��la S
Address: o-7 oz T S , 0 Ce AA c. �.�,� Company:15yp e r' C 0-� a f-�.e. - �Cg �s CS
city: :7-e--a MJ IRE—Act � State:FL` Address: Aoe,
Zip Code: Fax: City: LUC,(,e, State,'E(
Phone No. q50 ..,..46 79 " d Q ( -7 Zip Code: 3 Fax 77a--33 -Y3 a
E-Mail: Phone No 7 7ZL- On-7 ct -!1113 _
Fill in fee simple Title Holder on next page(if different E-Mail 5V Kr coo L S e r u�a t Q VA ash.-,e-,ow
from the Owner listed above) State or County License Ci''!,C D Y a:6 5 D
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
I.value of HVAC Is$7,500 or more,a RECORDED Notice of Commencement is required.
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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 aHermit 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 INTEN13 TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE
F C ENCEMENT."
gnature of Owner/Lessee/Contractor as Agent for Owner• ignature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLURlll , ,
COUNTYOF COUNTY OF.,•, --�•}- p.
The forgoing Instr m was acknowiedgViefore me The for oing ins u ent was acknowledged before me
this May of I -_. 2D (� by this May of 2Qjqby
Name of person making statement. �- Name of person making statement.
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Personally Known �!OR Produced identification Personally Known Le"' OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of t Public-State of Florida) (Signature of Nota P blit-State of Fiji )
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-;P °•.moi FRANCES V,JOANS p�YpU
FRANCES V.JdANs * 6Y COMMiS$)pN GG d 0
Commission No. * eaI)ypoMNiIS51dN#GG 030 9�ammISSIOti No.
Ny �� EXPIRES_Oc4o:er29,20 w� `ate EXPIRE✓:00obRr29,2 0
u, OF pLOF 9onded TUTU BudgetIV t,
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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