HomeMy WebLinkAboutBUILDING PERMIT i
Ai l APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED C
Date: Permit Number: V�O ' �U01
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 X- _ Residential
I ERMIT TYPE:
QROPOSEDIMPROVEMENT,=;LOCATION
Address: 109 �S 'S3� S-Ye
Property Tax ID#: n- ck�Ll - 00 S - 000 "q Lot No.
sit Ie Plan Name: Block No.
Pro ject Name:
`DETAILED DESCRfPTION:OF WORK'
�
CONSTRUCTION IN, FORMATION ,
, �' .;� ;�
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:
Cost of Construction:$ lJI'®(� , t'�O Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:- CONTRACTOR:
Name R1reno tiP- to��ieS 1-.0 Name:
Address: LAS4ala kl)T& JkNM Company: 9�Y-,qb coyis yiC-�ioyl Cpvh.
City: 'FoA �1 e_VcQ_ State: Ft. Address: 148E 13 N.
Zip Code: 3L{a Fax: City: ov-- PI e►ce. state: El,
Phone No, �7 7� �`�q-N3 .. Zip Code: 3ggTl. Fax:
E-Mail: :rY%- b(9 bm (7 ccwp, GoYrN Phone No -7 74,-97c)- ti1U.
I
Fill in fee simple Title Holder on next page(if different E-Mail
fr i m the Owner listed above) State or County License CSC= t5o�j�lo�
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
$UPPLEMENTAL CONSTRUCTION LLEN LAW INFORMATION:
1DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
,City: -State: City: State:
Zip: Phone Zip: Phone:
i
FEE SIMPLE TITLE HOLDER:' !Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
1Pddress: 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.
ink 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.
Tile following building permit applications are exempt from undergoing a full concurrency review:room additions,
acicessory 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."
Si re ntractor as Agent for Owner Sign ractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF. COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 3�day of 20 by this�day of r1,ev 20_iq by
Cctv�os �Yvt�oc>lq.
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 Identificat QS PABLOA.BREGOLAT
Produced Produced
N#GG 176593
anua 17,2022
rxrrlters
(S gna ure of Notary Public- ate of Florida) (Signnission
ic-State of Florida)
Commission No. (Seal) Co (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.