HomeMy WebLinkAboutBuilding Permit Applicationr
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: d )o ! Permit Number: ���
• ' At �{AY 2 1 1010
COUNTY
RINIIIMISSEIREMISMINEV Building Permit Application .trngoeP tU
Pelt. c,,?Cc'
Planning and Development Services St•�-�
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential v
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION. r - °
Address: a*y, N W Salty of SS be. PA-tm. c:/-y, Fk 2V990
Property Tax ID#: yy a(0- $0 s•' a0 I t 000- 0 Lot No.
Site Plan Name: Block No. 1
Project Name: _
DETAILED.DESCRIPTION OF WORK: - r
2ep Ie Cj IS'x 7 wood hoe cd/ lex7 /I/ i A,wi loth let"•
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CONSTRUCTION'INFORMATION: , ..
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator —Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ .300 . 00 Utilities: _Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Pel r P ler SOn . Name: J0Ki 1..vee2
Address:_aaSe/ Al 11,1 -rev ra j Ir. Company: 10 C 4 0;ce (ramie ovor's:
City: pp,I,rv„ e.ity State:FL Address: IN 7 SW WI:1(i k;41 Ave. '
Zip Code: 3y 9 9 0 Fax: — City: 'Par-t Sq. LtAcie State: FL. ;
Phone No. (77.7) 336. !fl 3 Zip Code: 3'/99' Fax:
E-Mail: Phone No(77?) 370- 40 9.6 I
Fill in fee simple Title Holder on next page(if different E-Mail c f/eQv Lily & yo,A00. C 0h,
from the Owner listed above) State or County License a&sY3 '
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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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 FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOT CE OF COMMENCEMENT."
Sig ture of er/Lessee/Contractor as Ag for Owner Signatu of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORID
COUNTY OF 51---C.2.c CJ--e--- COUNTY OF
The forgoing instrument was�aacck-noo ledged before me The forgoing instrument was acknowledged before me
this-2 day of r1 i2��r by this 'Lday of 0M-4-)__ 20_6 by
Ten c6)Q R- ,r -,1i
Name of person making statement. Name of person making statem_nt.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced ,F(./7 I Produced
(Signature of Notary Public-St e of Florida) (Signature of Nptary Pubic State o Florida)
�,��l VAUGHN
Commission No. `'YP '' Steteltlrid®-Notary Public commission No.
iq.. CommisslOn ##f�L3 27!)079 ,�o`'Y►�,,,
my
C�mml�glon SicF�irf�S �_ -_ . -
/,1�4o:State Of FIpN_VAUGHN
!rEoia y , • /_' .c ' 1-07'1,9"c�C
'�ann Qgt4bnP 22,•20?? �oQc` COmmissiCn #GG ,
REVIEWS FR.k _ - a _ "' •` ''-PLANS VEGETAT ►('@%;Q��� 'A TMR/Isimn-i ll(41 y',A
COUNTER REVIEW REVIEW REVIEW REVIE ,"ctober 2R,Emv,
DATE —
RECEIVED
DATE
COMPLETED
tev.2/1/19