HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE'COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: .. '3 1 3 Permit Number: ��� d3��
IVED
ER'C:E
AR 3 ?013
Building Permit Applicatio 9QUty� Permitting
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: 6�
P9,-,O E'D.I14 R V,, MENT:LOCATIQN
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Address: 2401 M�.10yj Cf J V& i' i-e-y i 34q8'2_
PropertyTaxlD#: a`�a1 CoZSS-dc�a.0- aaa � Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DE5CRIPTI�N OF WORK
o -e ^i rbo Md ct IAI i h rwa ~-e�
CC?NSTRUCTION INFORMATION ' �A
Additional work to be performed under this permit-check all that apply:
_Mechanical Gas Tank Gas Piping Shutters Windows/Doors II�� �
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft•of Construction: 25 sq Sq. Ft. of First Floor:
Cost of Construction: $ J a tAOd Utilities: —Sewer —Septic Building Height:
OWNER/IEECONTRA OR
Name Name:
Addres �� it,lz Company:
City: fb& vi-eyL{i State: -FL Address:
Zip Code:3"T2- Fax: City: State:
Phone No.(-7?1 Z) Z 4 - T1 I Zip Code: Fax:
E-Mail: CV��r�e mdej Af 0401 pjoo• Phone No
Fill in fee simple Title Ho der 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.
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SLtpPLEIVIENT�kL CCINSTR�ICT(f}N I:IEN LAW INFCIRMATlQN• T
/ pp MORTGAGE COMB:
DESIGNER ENGINEER: _Not Applicable PANY: _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.
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 subjectstructure
which is in conflict with any applicable Home Owners Association rules,bylaws or and coven antslthat."m'ay restrict&-'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 jobsite
before the-first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
L24,_,z_/ZF
Si nature of Owner/Lessee/ ontr z r as nt for Owner Signature of Contractor/License Holder
STATE OF FLOR�DA STATE OF FLORIDA
COUNTY O. COUNTY OF
The`q[ oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this i%going
day of 'W*-.g k ,20A by this day of 20_ by
Name of person making statement. Name of person(making statement.
Personally Known OR Produced Identification Personally Known 0 =4?roduced Identification
,,_
Type of Identific tion Type of Identification -
ProducedProduced
(Signature of Notary blic tla • f oridaCkANNAMARIEGIVENS ;(Signature of Notary Public-State of Florida )
MY COMMISSION#GG 022093
O< B •. mmlSSlOn NO. (Seal)Commission NES:December 16,2020
(rided ruNotary Public Unde.,?Jrr• 5.o
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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