HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: L I Permit Number: L
Building Permit Application
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Planning and Development Services �j9
Building and Code Regulation Division <GC/o 016,, O!
2300 Virginia Avenue,Fort Pierce FL 34982 cO �P�t
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE: ��un'L3; .
.P SSD I ' ROt(E�ENTelIN
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Address: C13l to fyaA-vreJ WG-�
Property Tax ID#: 0 lu " X00 " S Lot No.�
Site Plan Name: br-c.e ZeS Q,1 JVD Block No. $'
Project Name:
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Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric 6,1"Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ S-: S-0 dJt) Utilities: —Sewer _Septic Building Height:
%-as- �'�*" .�
ouutj ESS E: � �� �CC3NTRAC,TCIR � �
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Name "fie �r�cy� s:r toNe- Z. Lr �2 RN\eSa�p r� ame: fes'c�,r-.:!� 'Farr,,-
Address: ci 3 i to (Uak.)ceS wa.s. Company: 0_-e (, P10 n-.(0:
City: 'For- e.•ecce, State:j1L Address: I-L1 I S- S • u 5 l 1
Zip Code: 3 tial S Fax: City: a L(Q State: '�C
Phone No. Zip Code: Fax:
E-Mail: Phone No `1-1 Z- L( - Z8 Z
Fill in fee simple Title Holder on next page(if different E-Mail r Z e L ptjti�o:rw (a,
from the Owner listed above) State or County License C_rC, 1 Ll i'_9.3 L 9
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 orImore,a RECORDED Notice of Commencement is required.
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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:
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 EFORE THE FIRST INSPECTION. IF YOU D TO OBTAIN FINANCING, CONSULT
WIT O R LENDER ORWATTORNEY BEFORE RECORDING YOU OTIC OF COMMENCE
I
Sj ture of wner/Lessee/Contractor as gent for Owner SignAt6re of CoZRIDA actor/License Holder
STATE O FLORIDA STATE OFF
COUNTY OF COUNTY OF Y\,r,.,(N:
The forng instrument was acknowledged before me The forcing instrument was acknowledged before me
this�=day of�1r ��r� 20 1,q by this \1 day of 5e pLenht, 20 k`i by
Name of pe on making
/statement. Name of person making statement.
Personally Known V OR Produced Identification Personally Known ✓ OR ProduZdon
Type of Identification Type of Identification 1
tary Public State of owa
Produced Produced rn Lee Hite Commission G 3 402
pires 08/19/2023
Xignature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Commission No.GG3%- 0—L �0�' eallo�!yPublicStateofFI ridem ssion No. 3V)LW,a (Seal)
Kern Lee Hite
My Commission GG U67102
0811912023 -
REVIEWS FRONT ZONIN R S VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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