HomeMy WebLinkAboutBuilding Permit Application h !
All APPLICA LE INFO`MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED d(0~'D
Date: -4t Permit Number:
• 'RECEIVED
Building Permit Application20��
SUN �s
Planning and Development Services
Building and Code Regulation Division permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982
St.Wcic'County
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE: c
F �IcP.
PROPOSED`LMPROVEMENTLOCATION::
Address: E2-0t 6ccs .(-
Property Tax ID#: 3L102 Gd$– 6)40 (2'X7- S Lot No.
Site Plan Name: Block No.
Project Name:
D€TAILED-DESCRIPTION OF,,,WORK ., ,. ---
1r,sfi� i( aS o� 5 ` c���n 1►�1'� R,7cc— AS 5boL_n on juruc,4
cn�o Cf.
CONSTRUCTION,INFORMATION;
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ k 755. 00 Utilities: —Sewer _Septic Building Height:
01NNER/LESSEE CONTRACTOR
. _
Name AhtG r,^ Name: Sh AAo,n &6\e C�
Address: 5 toffs 15irch 0(` Company: f-enC:qq , &L L
City: f---k Q ierc L State:IFL^ Address: S(o 6-''t N vcrwc�c�c OC'
Zip-Code- 3.Aq o-- Fax: City: F-)-. N e!'l-G State'
Phone No. n
15 35 1 -?Z 7 Z Zip Code: I; Fax:
E-Mail: Phone No `3zt – 7SZ
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License 2�SS
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 GONSTRUCTfON LEEN LAW fNFORMATf01V f
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:
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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
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"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR'IMPROYEMENTS 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 NOTICE OF COMMENCEMENT."
Si6ndfure of Owner/Lessee/ ntractor Agent for Owner 5 ignature ontract /License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Sk-- LAA UAL, COUNTY OF S7� k k ("u
The forgoing instrunt was acknowledged before me The forgoing instrument was acknowledged before me
this��day of m 20 by this a day of M� 201� by
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
Producedf L �.� Produced_�( _ bL_
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(Signature of Notary Public-State of Florida) (Sign t�{�t or a`_jt6 ar�pidaic
Commission No. YP( i/ ELLE GHN =y Commission # GG 27007
V Florkl tart'Public Com 55e� ��� M Comml n Expire
* Commission # GG 270079 ctober 27, 2022
=a a: is o Expires
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°;; October 22, 2022
REVIEWS OR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19
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