HomeMy WebLinkAboutBuilding Permit Application 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
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential All'
PERMIT TYPE:
PROPOSED INP:ROUEMENT,LOCATION.
Address: I?L-t q dll+U S�aSe.�T L��.v C"'I0_CLi= LAL r-t L''ITV . � • `1��Q���a
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Property Tax ID#: el1lo2b ��3`-o�S6-do0 -�a 4&No. �
" RE kJ p&E� me �y
91kAZO :
v,�CA/s� .
Project Name:. Sff-A.6,u E 14,11
DETAILED DESCRIPTION OFWORK. .
Et 1 b f Q i�.� f// : i�(�
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all that apply:
Mechanical Gas Tank Gas Piping Shutters p<L Windows/Doors
—Electric —Plumbing —Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor: —
Cost of construction: $ Z�z 0'0Utilities: —Sewer _Septic Building Height:
OWNER/LESSEEA` " " CONTRACTOR:
Name P-oi3Fr-7 E . 4votp_'j .3PP-A&U P_ Name: FF,voe 6 E, A//c/�FLF
Addre§s f(6i-9- NW-_-"" k-EF_`iiAY Cl Company: :Q�"mt'/�QSSc�/.4T�5 LLC..
`CStater Address 14) 4,r
jy�/o00 _ CI k9CLE-
S
Zip..Code 990 ''` Fax: State: FL
Phone No..-C&'1-4. '/O/ 5�8 0 55 Zip Code: 7 Fax:
E-Mail: Ck�O� s,^r-S&Rol, <20M Phone No -:9-4
Fill in fee simple Title Holder on next page(if different ' 'E-Mail,4,v,oR_FQ .4,EM,4A604ss oc(t4Tr=S;, Cowl
from the Owner listed above) State or County License C 6 lsots®�
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.
UPPLEMEN:TAL CQNSI"R'UCTIO-N.LIEI LAW INFORMATION "
F
DESIGNER/ENGINEER: —Not Applicable MORTGAGE COMPANY: Not Applicable
Name:_ /Y Name: IV! 4
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 ihi t6hflict 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 jobsite
before the first inspection. If you intend to.obtain financing, consult with lender or an attorney before
commencing Work r rec6rding youpNotic6 of Commencement. '
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA ( STATE OF FLORIDA��� 1
COUNTY OF 1) COUNTY OF
The forgoing instru ent was acknowledged before me The forgoing instru gentas acknowledged before me
this 2- day of vi 20a by this_?_ day of v; 2011 by
Name of person making statement. Name of person malting statement.
Personally Known V" OR Produced Identification Personally Known 'I/ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
YP
tc-Stafe', i;'.P la) SEBASTIAN LOAI P [C-
OLD t a Commission GG 230820 .
*
Commission#GG 2306 N' �( �plres June 19,2022
>�,Commission No. eal xpiresJune19,2022 ` y
OF FV' woudIWBudpetNot2fySm Commission No.G.l�F1 ?�C °70' '�oFF1�Q S T�'�g�Cet1{olayeervlcea
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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