HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J
Date: r�Z7 'l Permit Number:17
_ RECEIVED
Building Permit Applic tionjUN I S 01
Planning and Development Services
Building and Code Regulation Division ST, L 0ci G.„ourit;y, PermltC ng
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential,
PERMIT TYPE:
P +
Address:, AAalckl ,e4v- A ��✓ r �'I�JZ
Property Tax ID#:,R0 - SSo3 - 03P 3-obo Lot No.
Site Plan Name: Block No.
Project Name:
D LED QED !P IO + (+}
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 s Pitch
Total Sq. Ft of Construction: 360( Sq. Ft. of First Floor:
Cost of Construction:$ 1'4 ,060 Utilities: —Sewer _Septic Building Height:
aWtU /L SaOISINR CTOR;
.NameTzcl- Name: ,4 (J �e
Address: 604-`1 �6CAIr/lhA (-(v- Company: t
City: R 'f?wcz, ') State:-6 Address:
Zip Code: 3-b 90k Fax: City:Q4 S4 1066 e— Stater
Phone No. Zip Code: 3--"'67 Fax:
E-Mail: Phone No-77oL X60 0/6�:6'
Fill in fee simple Title Holder on next page(if different E-Mail SkWeAku9_ 44i" Q ta"a1400 • COyy7
from the Owner listed above) State or County License /33 //'7b
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.
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 thepermit 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 As 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
"WARNINC 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
W1 L DER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Sig ature of Owner/Less ee/Contr for s Agent for Owner Signature of Contractor/Licen Holde
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Sit'. \.y c\e COUNTY OF 3)r� %-\)c\P,
The for oing instrument was acknowledged before me The for oing instrument was acknowledged before me
this V% day of v�- 20\1 by this R day of ZV� 20%"k by
Name of person making stateme t. Name of person making statem nt.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identific ion
Produced L Produced
(Signature of Notary Pu c-State of Flori Si 5 o ( ature of Not Ps�a State
F, eG62o y
Commission Nok,5 .o .� j ;'off; ,,( CQ� 2 �cem t �y�,de nye 3 p�RES:Decem Under+Riters+
—� S� �y'•�' •bt�c mission No. �. . �, �,ota($iy�
.�,.- o ed N
REVIEWS FRONT SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW` REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19