HomeMy WebLinkAboutBuilding Permit ApplicationAll APAICABLEjINF_ MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED A10-ozi
Date: i 13 1 PermitNumber:
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 ✓
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION: -
Property Tax ID #: 3 is3 S - �,n73 - (� i (`j�-(O Lot No.
Site Plan Name: Block No.
Prloiect Name:
LED DESCRIPTION. OF WORK: r
layov caz�J' L.dJ2 -
CONSTRUCTI.ON;INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank Gas Piping _ Shutters
y�Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
�, J.-too —
Cost of Construction: $ 3 :5 Utilities: _ Sewer _ Septic
— Windows/Doors-
Roof Pitch
Building Height:
.,OWNER/LESSEE.- ..
CONTRACTOR: = .
Name a -I-
Name:
Company: �1-i �1 /�/1
C .
Address: 0 (�7y, ( 00-' '
�l
ity: ` ).Q,n��� ,N Gie&c,l� State:EL
Zip Code: 3� (�l5'j Fax: Willa
Ic
Address: !1q/9
City: L--4"
&,eSS� �.
Stater
Phone No. 17 -
Zip Code:
Phone No % -
Fax: 4 Aar-
�}�/(0 SSA
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mailer WM e 1 ✓t C.
from the Owner listed above)
State or County License
4
IT value or construction is $ZSUU 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 -LEMENTAL'CONSTRUCTION=LIEN LAW INFORMATION ;
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE -COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: Stater
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 AFFI DVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commencedprior to the issuance of a permit..
St. Lucie Coun 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.'Piease consult with your Home Owners Associationand 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
inI 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,
a cessory 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. W YOU. INTEND TO OBTAIN FINANCING; CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT"
Sign wner/ Less rector as Agent fog O-fter�
ig re ontractor ' ense Holder
STATE OF FLORIDA
L�uA
STATE OF FLORIDA
S4 _ 44
COUNTY OF -C j
COUNTY OF c_( e_
The forgoing instrument was acknowledged before me
this ?0Idayof 1rz/ 20 by
The fo oing instrum nt s acknowledged before me
this dayOb</ 20Jby
/
66
Name of person making statement.;•
Name of person making statement.
:
Known OR Produced Ide t
Personally Known OR Produced Identification
Personally �>
Type of Identification
Type of Identification
PrucedCL
M.
Prod ed+'a;:,
c
ZmN•�
a
(S' - attire of Notary PukAte- $fate (if Florida a o y
(Sig. tore of [rotary Public State of Florida)
3 3 m
Commission No. r�3 c� (Se o
Co mission No. b 17 (Se' 1)
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REVIEWS
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'PLANS
VEGETATION
SEATURTLE
AN&'�t
COUNTER
.
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Kev. 217719