HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED //��1
Date: 1�t `� Permit Number: `GU`1 OD `
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FI. OFtIDll APR 082018
._µMM • Building Permit Application
Planningand Development Services Pe St ttmg Oepan'ment
P Lucie County
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax (772)462-1578 Commercial Residential 1(
1 PERMIT TYPE:
Address: �C7�� �il�Ve-�elS \.") Ec- Q, <,r c. LFL."5 cr.)-
Property Tax lD#: 3`k I 0"S6 -O� ���� � Lot No. 3-7
Site Plan Name: Block No. L
Project Name:
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/ ',/ fir'i,4,i�i/%�///i/a./..4000 ,,, / / �i /, % /�""
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator 1.--1(o-of I/ Pitch
Total Sq. Ft of Construction: 3 I Sq. Ft.of First Floor:
Cost of Construction:$ l I SAO Utilities: _Sewer _Septic Building Height:
//z'i aoy j
Na�meA(�c\r1.�n a.;cct Name: 1(4.. \
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Address: 6 1--1 1, Tray J c5$ t..tc,� (1
Company:S .y('- n-�e \; orj
City: , ,Q;e.-et--C... State:7-1- Address:5 73 5L. G-)-es,'L c(t. -13-(1-
Zip Code:J 11 3- Fax: City:GOV. S t:e-dr- C.L,c ,-tom State:F.__
Phone No.' Zip Code: 3`ketr-k Fax:
E-Mail: Phone No "l/)---a(o0 v 1 S 6S
Fill in fee simple Title Holder on next page(if different E-Mail, o el.rve.ry a f-. r c1_, 00 .(..w.Nn
from the Owner listed above) State or County License C.C_C{33% (-7 4 i
3W 8:9
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 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 INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NO ICE OF COMMENCEMENT."
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S'1; 4 ure of Owner essee/Cv ntracto . Agent for Owner Signature of Contractor/Lice
STATE OF FLORIDA . STATE OF FLORIDA
COUNTY OF TiAldrin COUNTY OF 1 l rim
Thej. going instr ent was acknowledgqckoefore me The f, oing instr ent wa acknowledged before me
this day of fl I ,20 11 by this jay of PH ,20 ‘Clby
and �i)i l 631 LI �
Name of person mi statement. Name of person making
statement.
Personally Known OR Produced Identification Personally Known Y OR Produced Identification
Type of Identification Type of Identification
Produced Produced
tfrUmo{ . ThOk Vrfk_ ci
(Signature of Not ry Public-State of FIo ila) (Signature of N to Public-State of Florid rp
.s4, BRANDY MOORS Urit.
BRANDY MOCRE
Q Commission B GG 102 mission No.�=J I��5 � ,, Commission#GG )2839
Commission No. I 8 1* =,a:. ,v
Tr`''- li Expires May9,2021 '^�``'0E-11f1.441.,hl ,
��rFof fa' bonded Pru budget otaryServ{CC9 7 O`y BondEXp uebudge bs May udget errlop�
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Zev.2/7/19
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