HomeMy WebLinkAboutBuilding PERMIT All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED `(Date: Permit Number: Y"1 0(14
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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
i PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: Y3 iropk I-(L Al� dl✓� «tr r� �S
Property Tax ID#: 3 66 r9 -4-21 "'Z 3 6 QCQ` 6, Lot No. �
Site Plan Name: 4ALc -nop 844-fr'I Z UK 4 cf Block No.
Project Name: �;wU—:' Woo 0
DETAILED DESCRIPTION OF WORK: �--
�' S PS � ^ �112 Z-,?9 41W
-br' 'e lJ
ve Leo
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator 1ARoof �� /_ Pitch
Total Sq. Ft of Construction: 3&2� Sq. Ft.of First Floor:
Cost of Construction:$ ��C�DI�. Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR: n
Name t1�trtnwu.�rP' Name: �t'�IiKWYt -P 1Rwft 17!3
oV-
Address: eg-6(, &e-wL ht4- LIB Company: U-Atlt#v, S. ag'1 r-t(j,X --r-.G
City: 4eI'-L I\ey-Ce- Stater Address:: 14Y3 .6- tsJru
j Zip Code: Fax: City: Z24 le-r4o State:
Phone No. `777-- -!a 70 Zip Code: Fax: )7Z-4�91
E-Mail: Phone No 7'77- 376
Fill in fee simple Title Holder on next page(if different E-Mail ei/m,,�,ClL°777 � -�
from the Owner listed above) State or County License
I
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
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 F NANCING, CONSULT
WITH YWR LENDE OR AN ATTORNEY BEFORE RECORDING Y UR NOTICE OF COMME NT.D1
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Signature of 0 e see on ractor gent for Owner Signature of Contracto A Holder
STATE OF FLORIDA I STATE OF FLORIDAq
COUNTY OF LA41 Q; COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day f 120 by this day of •20_ by
ZTA
Name of person making statemen Name of person making stateriabrit.
Personally Known —�OR Produced Identification Personally Known FOR Produced Identification
Type of Identification Type of Identification
Produced Produced
�n LL�'�
(Signat re of Notary Public-St re of Notary Public-State of Florida)
LASHAHNAINGRAM• MING
Commission No. TV*YCOMMISSION#GG umm sion NoE� o
�.,
` rQo= EXPIRES:December'2 ,2022 IASHAHNAINGRAM-RAHMiNG .g
FOFF�� WYCOMMISS
EXPIRES:DeceREVIEWS FRONT ZONING SUPERVISOR PLANS VE &EA�rTil , VE
COUNTER REVIEW REVIEW REVIEW R
DATE
RECEIVED
DATE
COMPLETED
iev.2/7/19