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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I Date: Permit Number: G. 5 y'. x kdU v _ 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: fpe�,,,•� -f K W ,PROP®SEDIMPROVsEMENT LOCH N , . ,,._ ¢x. � , (Address: S I � Property Tax ID#: Lot No. Site Plan Name: Block No. j Project Name: O 7-W r h LA Kf"'- '" l/h / M-5 h`s..- :✓`' t K._, �. _,,,r f_' ,,,,u t r 5, a: 4 .y " r-g ;- .;. t .x d � n D;ETA'ILED'DESCRIP�TION OF 31 " ` dlAa f 2 qlci 1/017�' tCONSTRIJCTION INEORMQTION=: <� Ii 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: Sq. Ft. of First Floor: D� Cost of Construction: $ Utilities: _Sewer —Septic Building Height: CONTRACTOR ;a4,Ser,ic, .r.� _�ai. L ..G+ �K, z.r., id e ,C?4 ..-#;,. ,�✓ .� '" ;'^ ;�o-'r.�.!"„ Name s z-r-N V�JC© Name: ikk.Wrzo.z5 Address: Company: /1 nel t)rn City: State:— Address: A 7Z-6 Sh/�5-i Zip Code: Fax: City:_A /-0 A-r/ State:PL� Phone No. SC`�_ �_ Z Zip Code: -6-3/6 s Fax: E-Mail: Phone No 'o �fsd" 32SZ Fill in fee simple Title Holder on next page(if different E-Mail d Z� / R7 •+� from the Owner listed above) State or County License ��a✓% 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. I PPLEME,NTAL CONSTRUCTION LIEN L`AW IN°FORIVI`ATIO'N Jam., G,h DESIGNER/ENGINEER: _ Not Applicable cMORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: Af- 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 "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 UST�.BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU . END TO OB AI FINANCING, CONSULT WITH YOUA1 VNDER OR AN ATTORNEY BEFORE RECORDING YOUR NPff ICE OF COMM NCE ENT;' ature/ Owner/Less /Contractor as Agent for Owner Signatu"re of o tractor/Licens Holder n STATE OF FLORIDA STATE OF FLORID COUNTY'OF_� COUNTY OF C,9�� I The forgping instrument wa ,acknowledged before me The forgoing instrument wasacknowledged before me this day of Ste' 201 by this day of 3'C 20A by Name of person makingstate ent. Name of person making sta ment. Personally Known. y 4F0 M Nication Personally Known !/gs OR Produced Identification Type of Identificatio Type of Identification Produced o -STATE OF FLORIDA Produced omnw G 254407 Ores 8/30/2022 (Signat r of Nota c-State of Florida) (SignatuTeTof No y Pu nguez e ARY UBLIC Commission No. (Seal) Commission No. STATEQ1§LFl9RIDA Coma GG264407 Expires REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.