HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ' �` \\ Permit Number: \�a� OW t
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_ 1319.
a Building Permit Applicati
Planning and Development Services , Permltting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE: rLE' r2r0o% s r-�s.�s trr
PROPOSED IMI?ROU� SEN LOC T O
Address: 24x8 ff0Lj_D!j COQI-r , FoXf PZE4-C&,T-11 3Ylea
Property Tax ID#: Zy11. 604-002?• 000' 8 Lot No. S
Site Plan Name: Block No.
Project Name: 1Z6S-9• Si cucLE 0009J�;
*L__fWM DI=S.0«RIPTION OF WORK:
/ZE'P L.*'C C- S 1+54aC c C-S A•'r LOG; C CC S-7.%cic- E-e- LA,,r�LAJ T
OWNS STRU ION II NFORMMA MI
Ad'dition�lworktobeperformed under this permit-check all that,apply:'
Mechanical —Gas Tank —Gas Piping 13: '7-r S- utters _Windows/Doors
_,+Electric —P.10mbing _Sprinklers "=f Generator _Roof 3 1.2. -Pitch
Total Sq:',Ft of Construction: 1420 s�f� Sq. Ft. of First Floor: F PZ0 s?tj
Cost of Construction:$ 11.6 35.00 utilities: +_. Sewer v Septic Building Height:
A (J 4
0 NER/LESS�E: Ct�NT ACTQR:
Name,,: 8 neo. iZ .� Namei':''�4;�ANNi G�Qcsa
Adress: .?102 IfOL-18AI comet Company' F-t0`spa ray r&Uft0 &0oFsN6 ,awC
City:.'_:..�o4T State: FL Address`.-'i0y S . ►' "LE f
Zip Code: 3y99t Fax: City: State:f-L
Phone No. 7-7t-y68-3109 Zip Code: 3 Z 9y8 Fax:
E-Mail: Phone No 3-72-A/91q- Y,56`1
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License Ccc 13316.01
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.
UPPLEMENN CUNSTC{UCTION LIIENI 20,10 A-011
DESIGNER/ENGINEER:'- a/ 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: •iNot 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 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
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Signature of Owner/Lessee/Contractor as Agent for Owner Signatur ofractor/ 'cense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY COUNTY OF S-04 61A&5 ej.ycZ,
The forg�ng instrument was acknowledged bef, re nv R The forUing instrument was acknowledged befor( a R
this 2 day of "G JJI' 20/9 b CPA� R this 5 day of /W cod t .20ff 9 by a R
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LL N LL
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Name of person making statement. W Q Name of person making statement.
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Personally Knowny OR Produced Identif cM rn Personally Known v"' OR Produced Identifica 1H
Type of Identification g Type of Identification a
Produced = X Produced _ W
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.QoP.c ,2)OILt .cam .2
(Signat re of Notary Public-Stale of Florida) — (Signatur of Notary Public-State of Florida)
Commission No. 1: 5'y9�Pa (Seal) Commission No. irr9Y9/8a (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.