HomeMy WebLinkAboutBuilding Permit Application` II APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
IIDate: 10-1 1 1') 9 Permit Number:
_,..-_.........-...._....._...�_..,._._.___._ 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 V
PERMIT TYPE: E I ec-4- iC.0-1
Address: E-39l cjS>l�er .� lbr , R 0e0cQ-, R 39SSo
J
,Property Tax ID #: ���c�- c�'1-I��-�� ^� Lot No. 5�-
Site Plan Name: Block No. q
Project Name:
Additional work to be performed under this permit - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing — Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
00
_ Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof Pitch
Utilities: —Sewer _Septic Building Height:
Name ._ I(1hn 0. WQZQ.r
Address: 5c0q- S lge-r
City: Re-r ce, Stater
Zip Code: , i % S D, Fax:
Phone No. '1'l-4- 5Q2 � y
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name �I (71 T lU _
Company: l `D.rlx -ko-
OnAa
Address: \A
City: St'a1ter
Zip Code: ,,�JLiL'IRC�c�- QFax: LVO\ `-4�5�
``
Phone No `� 0�-
E-Mail � n-)esmnAujo`lz �`W\
State or County License ` 4 �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.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone:_
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
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,l 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 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."
Signatulewner/Lessee/C ntractor as Agent for Owner
Signa of Contractor/License Holder
STATELORIDA ��pp —
STATE OF FLORIDA �y J)
COUNTY OF ,'� k-ArX 2i
COUNTY OF hPXx�t:
The forgoing instr ent was acknowledged before me
this day of 20q by
The forgoing instr ent was acknowledgeA before me
this day of 20 by
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 Identification
Produced
Produced
' n ture of Notary Public -State -of Florida)
igna Pub ' State of Florid )
Commission NO.
LA
Comm sjp �o '" RAM
G M e )
C MG .RAHiMING
P;°o' 10 RES.' DMINber 70 80
•'st'""�ti••. GG 27506p
a'
.;
December
0, 2022
7777 O"IMANGROVE
IfyPubb Uwemflers
REVIEWS
Pubku
OR
PLANS
VEGETATIO
W
REVIEW
REVIEW
REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 217119