HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:�`ab� Permit Number:
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Building Permit Applic;4MPlanning 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
PERMITTYPE:
PROPOSED IMPROVEMENT LOC TION:
Address: S' R1 k lJ 3 2—
Property Tax ID#: I I��^] ��1 SM_ DO�- , 00 G Lot No.
Site Plan Name: Block No.
Project Name:
•DETAI`LED DESCRIPTIW0F WORK.
G�(' G P 0-,I K - ►n I S k C00 ct-
n C A r i V e-VJ(R/v, 3 Goo PSS LJ/�.cBF
Fc_qsvO'N;INFORMATION ;x
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
a
Total Sq. Ft of Construction: 1 I' 60 s T (-PP fG� , Sq. Ft.of First Floor:
Cost of Construction:$ �(30 G G Utilities: _Sewer —Septic Building Height:
01NNER/LESSEE
E ra CONTRACTOR. . u
x - - -
Name �ffiq
' ►�- - _ (OYII NName:
T. MADD=1�
Address5 • h R �-► ' Company: 12 J. (7�17�C S 4S�.,-�a+� �
city: �-' t P 1nn'E-�L� State: F L Address: &2gN1a ��� S�_
Zip Code: 3�� vl$ 2 Fax: City: Tv Stater
Phone No.( 1 } ' I 7 Zip Code: FLIFax: eV1i7,
E-Mail: Phone No 772 -1,311-VIS-11
Fill in fee simple Title Holder on next page(if different E-Mail 1,,Ppz)e>YG,Rv7'&YAoY&6, o&
from the Owner listed above) State or County License CGG d 4(7334o
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.
SUP"PLEMENTAL,GO NSTROCTIONIIEN LAW'- NFORMATIOW- f 7-
-
,:
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 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,l 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."
Signature of Owner) see/Contractor as Agent for Owner Signature of Cont or/License Holder
STATE OF FLORID STATE OF FLORA,p
COUNTY OF �tC l-t, COUNTY OF =7P-Li t e,
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this le day of �?1YfbP,y,20/ by this L day of 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
Produced Produced
(Signature of o a tic-State ILIM�$ (Signat a of N ublic-State
Commission No.C~6 25-09 '� �#GG F�i
,2022 Cnison No6L-W-SC}57.3 �,,k EadadfintroyF�teintrance 70`
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.277119