HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE IN z0 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ` I
Date: l Permit Number: b 0v
�ft
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
RECEIVED
Building Permit Application .Nov 2:6 2019
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Permitting Department
st.. Eael@ a®dRty
Commercial Residential
Address: /0/ 02 .5 oGc'n7v Pez, T—o? A`
Property Tax ID #: q-t-0, Z— e02-. 6vyl w— / Lot No.
Site Plan Name: �/`7 ✓1�v j Block No.
Project Name: �' `9• ,v,S
DETAILED DESCRIPTION OF WORK:
tqak&,-V�� I _P/-forlr~
[CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters >4— Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 5'_57-W C)O
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Ofa& UC,
Address:. ?i
Name: IG L (�m�w •^,,%/
Company: �fEtr l�il�/G>•�ti�►.aiy
Address:-64'17U VN
City: 5U/V502ts&5- State:_
Zip Code: /31 Zf Fax:
Phone No.y r y — 'T%
City: �� State:/2
Zip Code: cJ S' ��1 Fax: a
Phone No 6,f 2 O042;J
E-Mail
State or County License CC /r�55,f 5,7
_
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
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.
SUPPLEMENTAL CONSTRUCTION �LIEN -LAW INFORMATION:.
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name: �Mm"40 Name:
Address: y a Gi- Address:
City: Veno ( State: _� City: State:
Zip: �1,2Q Z Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable I BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
Name:
Address:
City:
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, fen s, walls, signs, screen rooms and accessjJE
ther non-residential use
"WARNING TO N R: YOU A L TO RECORD A NOTICE OF COMAY RESULT IN YOUR PAYING
TWICE FO IM EN S OUR PROPERTY. A NOTICE O C NT MUST BE RECORDED AND
POSTEDN T E OB TE RE THE FIRST INSPECTION. IF O BTAIN FINANCING, CONSULT
WITH YUR L ER A RNEY BEFORE RECORDING YO R OMENCEMENT."
Signature of caner/ Lessee for as Agent for Owner
ignattire of Contractor Licens�Holder
STATE OF FLORI
STATE OF FLORID
A�
COUNTY OF ,Q� V�7/I\/
COUNTY OF
The f 'rgoing instru iNt w s ckno le ged More me
this day of 0
The grgoing instrument was ac nowl dge¢ be ore me
this Z day of 20Llby
Name of person making statement.
Name of person makin tatement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signat re Af Nota Public- State of Florida) I
(Signature of Not Public- State of Florid
Commission No (Y_ (Seal)
Commission No. '��� (Seal)
REVIEWS
cletC
s
R
oflM
PLANS
REVIEW
A
VEGf
RE
V-An*erseo'v'vll
VE
DATE
My Commission G
Expires 07l04/202�a
235102
Expires 07/04/2022
102
RECEIVED
DATE
COMPLETED
Rev.2/7/19