HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: A 1(0
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 VVV
PERMIT TYPE:
Address: 6�—�� r %i /c PL, Eagx iz �'G►
Property Tax ID #: -!' t— Ot (02 — O(Z (//. > Lot No.
;Site Plan Name: (7R�/ L (26"Q Block No.
Project Name:
Additional work to be performed under this permit -check all that apply:
Gas Tank Gas Piping. Shutters
— — —
- r Electric _..Plumbing _ Sprinklers — Generator
T,otal:Sq.!,ft of Construction: Sq. Ft". of First -Floor:
Cost•of,Construction: $ v- 300 „ d`O Utilities: —Sewer —Septic
Windows/Doors
Roof . Pitch s.
Building Height:
OWNCR/LEASE-E:
CONTRAS R:
Name F/?�L� /�d� ,n tg Q-
Name: 1� M
C_,]S
!� �r
!Add ,res5: %�� (.C� /�i3l,02L l..I ' �
,city: JR/ a /�, State: LL
Zip Code: e3 2f — Fax:
a
Phone No. le �96 y0
Company: i b r L �--••� f - .
�Addrees-sr:-�0 k OSCi LXI�
City: o
n
Zip Code: 23'4G "1 `Fax:
Phone No 00n
ate:
E-Mail:
Fill in fee simple Title Holder on next-p ge ( if different
from the Owner listed above)
E-Mail Go I\ e 1-(Tac t
State or County License L-Ln C_ 01 t9 2�
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.
SUPPLEMENTrAL CONSTRUCTION LIEN LAW INFORMATION:
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 or.and covenzints.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 AWATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Owner Contractor as Agent for Owner
ign ture of Contractor/License HoldeL
RI A
STATE OF FLOR DA
F �Vi
Len
COUNTY OF I.�fiVl
instrument was acknowledged efore me
of Q �}Q(/ 20by
The for off' g instrument wasa�ckn9wledged before me
this ay of ��)YXJV 20 tia by
on making statement.
Name of person making statement.
o
Personally Known OR Produced Identification
Personally Known OR Produced Identification
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Type of Identificatic
Type of Identification
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Prod ced
Prod ed
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Oature
lic-State of Florida)
t%M
ign.'ature o otar Publ�ic"=St�a�t(e�of�FlofidaommissioO
(Seal)
Commission No. 11C WO (Seal)
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS ..
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW,-
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/ 7/ 19