HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Numbe
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
PERMIT TYPE: �/��f ��d �l%lh �akl l�C��►p�t,-�
Address: . �p?,�1 �p1>J�r ���� rort iPilirc' 3 9'YY
Property Tax ID #: 3, 3 3 Z. O Oli D �LO{j Lot No.
Site Plan Name: Block No.
Project Name:
Ae,m z avi& Re:rrolac,e ogle. s0l � Iris door Wi+h m4p4c- k)Or .
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: $ /` 609, �� Utilities: —Sewer _Septic Building Height:
- - %.
. - _
Name o tiew ;rane ;ranus
Name: 1,owk rblomo
Address: l YQ cop en q
Company: 1 l,ri l/ bk Im
City: ' $w PI'fiY`C.�' State: `��`
Zip Code: ' ��9•�1 "PP,Fa'x:
Phone No_'" 32.-. �'�" .•9;0�3 a
:-Address:; 2y�2. S� -wi;c, t SJ
City:,��'T -5� .'G'V ae; ='•' ':' - State:
Zip Code:3 �� ` Fax:
Phone No::7
E-Mail: 1- 20Y1 V� 4 0�%
Fill in fee simple Title Holder on nex page ( if different
from the Owner listed above)
r ,
E-Mail I CO ID W %s in'1 I �i OW
State or County License
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.
dress:
City
Zip:
INEER: ,P% Not Applicable MORTGAGE COMPANY:
Pho
State:
FEE SIMPLE TITLE HOLDER: Y Not Applicable
Name:_
Address:
City:
Zip:
Phone:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone: -
V Not Applicable
State:
)V' Not Applicable
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
w.T., vnirn i Munro.nD wru ATTnD1U5:Y BEFORE RFCARnmr. YnUR NOTICE OF COMMENCEMENT."
Signifture of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA,
COUNTY OF SV\_1 , r,'S
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrum t was acknowledged before me
3 this\day of 20_ by
this � day of 20k? .by
N.
�l`l1•t�n n,
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 Identification
Produced
Produced
r
(Signature of Notary Public- ate of Florida)
(Signature of No, Public- tat
Commission No. ' LA INGRAM-PAHMING
b -.s;+ v;^ LASHMNAINGRAWRAHMING
Commission Flgi'._'�'' s '':= ; ►�AISSION#&-A060
9�.,
MY COMMISSION # GG 275060
r� �P; EXPIRES: December*20, 2022
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REVIEWS
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Thru
ublic Underwriier
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PLANS
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VE� ATION
SEA TURTLE
MANGROVE
COUNR
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
-
COMPLETED
ev. 2/7/19