HomeMy WebLinkAboutBuilding Permit Application 'y
Jl '
Ic)
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
PERMITTYPE:
a,ca. -n.: ,r-• �'X v,:✓, g,.r..r.,+sa -.+a3't-�4�F*.r r .y4. !a�a}.»--+, yrs: �'yf i5>�i -S� 'S '
,i` `.,A tira'' t"'ahz
�y!`,r+• S y�Fcc
`
Address: _ Ol '� `��l .eT /E/QeE T�.
Property Tax ID#: �y�s 20 t ' L Z T 11 4) Lot No.
Site Plan Name: CD lei4 L rO-WE J99Sig CO-4 tti enaptD Block No.-!7 -
Project Name:
.2t+ t r .. a:'L53'�4,t -NS-3t s..: r •i-ez o a s r'"f'ti F
` iNa' L�;Y 4i,ySn., .�"t` hKT-'c� il,4kE• ,.$.., aFYPK,'� ,t�i�;r#� .. ":'G`e'�k fi
� � '�'' �.��',1,.•�k*3,,-�
Ag:-r.'1,r�...�,`-s�.-.�r,�-�aat�4w�..�-.�.a:x°-�.-'&i-�..x�.t'.t•.,x.�:r,.,sC=<� �'3rk�'c�:e"�•.°+_�»3x.�r �`��s�.+,,,4e��.k;�:�:•s:�;� ,�wu.�;w,•�`�`�{�;'�,k:,�?.r•3` �....t..z.�_.z_,.,�.....,
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: a2�� Sq.Ft.of First Floor:
Cost of Construction:$ l6�� y Utilities: —Sewer _Septic Building Height:
Y`x'.':.f k ,.-�,..� Y i;:r.�.s*��fi..-%:"'�,d z"'�'F<uv,^+�,5,'::k��- ��1.d ��„•..+,ce���zaf'..�'�:- cs3.^�s..G pn+./`y�gai•,as ',p�}'..�-s-.;...;k.1til'�'z'� F3�k�:'��s._zC#.-3��4_�ae-a,t,-�iy�',�4_�,
3.�S �. e- s�.�:ya�7�b...;;s`�.�,� r�X�„r e'�+,..r '��`��-y 1. s'�• �
��} �c'
� 1tr/ IIfRESSfE � vhYr ..��:�.
Name E✓'t d Name: "JI7 Hottvc-Lts O
Address: I- 0-4f- Company: /*Sr /�oQt¢c
City: lt 0 1-Vsy, State:FA., Address: & 6oW arz& 100fe
Zip Code: 33!y Ste$' Fax: City: S State: •
Phone No. NOW - 440 yS= 0 Zip Code: '5
g Fax:
E-Mail: Phone No SZ - 47?71 - 1QtiZ)
Fill in fee simple Title Holder on next page(if different E-Mail ADA
from the Owner listed above) State or County License C.6 C C13 21,5—
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.
IJC3I471MCK/CN�7INCCK: _IVUL/Apt IiLdU1C MORTGAUL GUMPANY: _Not Appllcame
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,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
"YARNING 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 YOU LENDER OR,AN A RNEY BEFORE RECORDING XQUR NOTICE OF COMMENCEMENT."
Signature o ner/,1e3�s'ee/Contractor as Agent for Owner Signature of Contractor/License HnIrlpri
F .
STATE OF FLORIDA�, N STATE OF FLORIDA
COUNTY OF INMai rh V1 COUNTY OF ktu* ✓I
The for ing instrument was cknowledged before me The forgoing instrument was acknowledged before me
this Nday of 20 by this 7A day of 0 OU Pit' ,20 I(by
Name of person making statement. me of person making statement. cR-T o•
Personally Known _OR Produced Identification Z P rsonally Known OR Produced Identificat'
Type of Identification s ae of Identification g
Produced a a ' duced
Ua
= a 3
Z
3 H vm 3 iTm
R,a� �xoii�
o - m _m
.#N c
d n�+ n a Llan
•
*!oZ
ef Notary Public-State of Florida) a a N -' gnature of Notary Public-State of Florida) w
Z p A N Z
N O O �M
Commission No. CD
3u (Seal) w a mmission No. Cr►6i3 c,�JU (Seal) = W
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.