HomeMy WebLinkAboutBuilding Permit Application 1
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division J
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
t ri.
PROPOSED IMPROVEMENT
Address: 6 y l _t-4 ' z, ,_ c_ -1 4:�,
Property Tax ID#:
'I �'f 2- -boa-o y3- o o�- Lot No._�_
11
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF�WORK
I
a t h
CONSTRUCTION
...tl:..,�
i dditional work to be performed' under this permit-check all that apply:
—Mechanical —Gas Tank —Gas Piping —Shutters Aindows/Doors
Electric Plumbing Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ i ;LO D Utilities: —Sewer —Septic Building Height:
r•i - �v -. v 4 r - Xty S-0 y 7 ik ''-H'-
OWNER/LESS'EE �� x :CONTRACTOR 3
Name Q X \,F- ,.l DI 0 I S 1^rls Name: o
Address:a q IVcy is Arc, Company-3om`c,j
City:(-k. QJ �ryc- U State:FL. Address:1513 tV (,le-nide- A.
Zip Code75gg /V Fax: CityTb(-(-Sa;* Lmc;< _ Stategi-
Phone No. Zip Code: 3 H 1 k:7 Fax:
E-Mail: Phone No77,)--dA.O - S$
Fill in fee simple Title Holder on next page(if different E-MailskD
from the Owner listed above) State or County License Ce-c-1 1�5 B:1,0
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.
I I
SUPPLEMENTALGQNSTRUCTfON LIEN LAW INFORMATION; "[, X 4PtFJ t ' r
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 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
iI n 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-9N THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH/YO,O LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
I
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Sign ture of Owner/Lessee/Contractor as Agent for Owner Signature of Con ractor/License'Folder
STATE OF FLORIDA CSTATE OF FLORIDA` d1Q
COUNTY OF vl, ��Q. COUNTY OF Com. _L S�
The forgoing instr ent w s acknowledge efore me 4Name
!forgoing instr nt was a knowledg efore me
this�day of n 20� by day of �1 20 by
Name of person making
statement. person making
statement.
Personally Known v OR Produced Identification Personally Known ' OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature ofo ary Public-State of Florida) (Signature of Nof ry Public-State of Florjya)
/'�� q �rRY as BRANDY MOORE �� ��o „. . . • BRANDY MOOR
Commission No.W�o2U3 °''�� ��al it 2'� �Commisslon#GG 10 8
� ) Commission 102 2@ommission No. . t!"' eel
Expires May 9,202 �; Expires May 9,20 1
~ ole keg ~�'��«��� 13mcledThruBudgelNotarye e
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19