HomeMy WebLinkAboutBuilding Permit Applicaiton I I
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:J �I )�� l/✓�
• JUN l
Building Permit Applicationper��tfn
Planning and Development Services SF Lu C my enr
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 5110) '511'Ck D f• f oI+ Vat Ce
Property Tax I D#: o0o,17- Lot No.
Site Plan Name: Block No. II
Project Name:
DETAILED DESCRIPTION OF WORK:
FCONSTRUC'T' ION,INFORM'A'TION:-
Additional
work to be performed under this permit-check all that apply:
Mechanical —Gas Tank —Gas Piping —Shutters —Windows/Doors
— umg —Generator Electric Plumbing Sprinklers GtRoof Pitch
— — p —
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 3,�od Utilities: —Sewer —Septic Building Height:
OWNER/LESS' ..CONTRACTOR:
Name Sgr'eY Fi lkir Name: c+ �tawSTlca,,.
Address: 5210 birch (3r. Company: �ual i+
City: for-+C��uee State: TIL Address: GS38 CAMIS Nt.
Zip Code: S1G 01- Fax: City: MIAN ZeU Gln State:IFL
Phone No. 50$- 9S1? - li553 Zip Code: Fax:
E-Mail: Phone No 00 1�3 7 y 7
Fill in fee simple Title Holder on next page.(if different E-Mail Quallivolt 6afwlta 'k-(01
from the Owner listed above) State or County License g
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.
SUPPLEMENTAL CONSTR'UCTION,LIEN LAW INFORMATIO,IV:
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.
Inconsideration 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 accessoryuse o another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COCEMEN MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF MMENCE ENT MUST BE RECORDED AND
POSTED ON T B SITE BEFORE THE Fl)ft INSPECTION. IF U TEND OBTAIN FINANCING, CONSULT
WITH YOU ER OR AN ATT RN BE O 1 R CORDING YO IT
COM ENCEMENT."
i
Signatur�f Owner Lessee ontrac i r as A for Owner Sig atu e o ntractor/License Holder
STATE OFF RI STATE O ORIDA , \
COUNTY O SSR W COUNTY O
The for�ping instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 7 day of JfJ•� 20/� by this�day of _T U(\1Z20_ft by
J e & ±Mncr; M 7DM�_
Name of person making•statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identificati n
Produc — 0 'C Produced
(Signa ure of Not Publ - tate'of Flo r da) r otary ublic of orida)
Commission No. (Seal) Commissi o. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW,
DATE
RECEIVED
DATE
COMPLETED
eV.217119 ;'o� °e': STEVEN LEVY ;� v'd STEVEN LEVY
_ .� G: �B�
�; ��!'a; Notary Public.State of Florida
a,: Commission k GG 255569 '?°•_'��= Notary Public State of Florida
oFrt°° ao Commission#GG 255569
My Comm.Expires Sep 5,2022 '•'. oF F o? My Comm.Expires Sep 5,2022
Bonded through N