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Building Permit Application
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (('� Date: Permit Number: tqU)' 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 d PERMIT TYPE: Address: 9 SS4f (I AkC-440At ! Af Property Tax lD #: 3 0'�3�' 33% "��� ��`.5 Lot No. Site Plan Name: Block No. Project Name: j Additional work to be performed under this permit— check all that apply: r _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: $ 0 0s GCG Utilities: —Sewer _Septic Building Height: ION' N'i8=I=ZS-S E: CQNTRACTCIR: Named ah-{ 4 C.- Address: 5&)/c z' Name: J* es00 %• Company: = City: 4�w` e State: _ Zip Coder G� Sib Fax; -Phone No Addles City:' G!1' .�.: Stater Zip Code:.��. Phone No E-Mail: Fill iri fee simple'Title_Holder on next page (if different from the Owner listed above) E-Mail 06AO State or County License 19eel& 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 CO'NST fUCTION LIEN LAW 11NF©RMATION: DESIGNER/ENGINEER: Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable Name: BONDING COMPANY: Not Applicable 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,gf•�and,covpnants that_may:restNct.&.. prohibit such structure. Please consult with your Home Owners Association and review your ddeed for'ariy restrictions which may apply. In consideration of the granting of this requested permit, I do here'U j`agree`tHat'Fwill ,in11all4respects; 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 WIZtrYbUR,LENDER OR AN':ATTORNEY�BEFORE,RECORDINVC YOUR NOTIGE'OF COMMENCEMENT:" ^` re o(Jwner/'Lessee/Contractor as Agent for Owner I SignVure of Holder STATE OF FLORIDA STATE OF FLORID���,, COUNTY OF + 4 COUNTY OF The forgoing instrument was acknowledged before me this �_ day o 20A by Name of person m ing statement. Personally Known OR Produced Identification Typ of Identification Pro iced The forgoing instru nt was acknowledged before me this L day of A 20_4 by Name of person ma ' g statement. Personally Known OR Produced Identification Type of Identification ' Produced ( ignafe of Nota:.r ( igAture of Notary Public=',31:ate•of Florida^)U.•' •.:`.LASHAHNAINGRt1M=RAHMING Commission No. .: cr'fdY'cOMMISfq@Nq,GG275060 Commission No. (Seal) EXPIRES: Dgoember'20;2022.,'-.�� ' a 's;uaF��Q` Bonded.1-14.. I..bl...... twriters t,4v'i-r;;, ZONING` '.:' SUPERVISOR PLANS VEGETATION �X *: My COI I SSIQN, � 6 REVIEWS FRONT- "ar •ORT IR S.��C21titf3 ;2022 "COUNTER REVIEW, REVIEW REVIEW REVIEW e`f( P�t WndedTh Noi KR derxrite DATE — ti RECEIVED ` DATE COMPLETED