HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _
Date: Permit Number: 9 07" d I g J
® JUL 0 9 101g
-- Building Permit .ta
Applicq# n.
ermng Department
Planning and Development Services St. LUCh county
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential l�
PERMIT TYPE: ee c ywl
PROPOSED IMPROVEMENT LOCAT[ON:
Address:
Property Tax iD#:i{\O Sol o n b oo 3 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Sr C&l
CONSTRUCTIONi 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 woof Pitch
Total Sq. Ft of Construction: 2G00 Sq. Ft.of First Floor:
Cost of Construction:$ /Q, oo d Utilities: _Sewer _Septic Building Height:
OW
NER/LESSEE: ' CONTRACTOR:
Name Name: 4,4,nej tdilfq
Address: d�'� c� Company: .S l
City: - F c tz State-EL Addres : /�/73 (J
Zip Code: `�$2 Fax: City: f,s-E loefse_ State:
Phone No. Zip Code: 3`fyd-7 Fax:
E-Mail: Phone No"77D. p?C�D WSh
Fill in fee simple Title Folder on next page(if different E-Mail 6 e- 6-O
from the Owner listed above} State or County License C 8.3/no
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.
7
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _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.
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
PO N THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
ITH Y ER OR ORNEY BEFORE RECORDIN U NOTICE OF COMME CEMENT."
Sign Lure of Owner/Lessee/Con rac r is—Agent for Owner Signature of Contractor/License old r
STATE OF-FLORID STATE OF FLORIDA�
COUNTY OF COUNTY OF
The for oing instrument wa acknowledged before me The f oing instrument was knowledged before me
this day of 20 /Eby this�day of 20�by
Ro in JW oA j A-V') '_,1L
Name of person make g statement. I Name of pe son making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification/� Type of Identification
Produced Produced��
E L
(Signature of Nota f(s1 Fi'sd�Je-Notary Public (Signature of N b ' fE06fl4dcl3}blOtery Public
mm ssion #GG 270079
y �e �,� ommlaslon #00 270079
,�o o�o�;,, My COmml®�`Ion Expires %'�o It ��� My Commisal IreS
Commission No. ""�"` OctddRia02, 2022 Commission No. '"/j"" CstAbNr ZY'Q�'�2
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.