HomeMy WebLinkAboutBuilding Permit ApplicationAII"APPUCABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
'COUNTY
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
Building Permit Applidation
Commercial
ential 'X
PROPOSED IMPROVEMENT LOCATION:
Address: i i--( r� � I , Picic) Fvh:�3h trn04- F4- 1 rPP,. M ;�ZFWCI
Property Tax ID #: ILh4 -7u-0=- Lot No.-ri
Site Plan Name:
Block No.
DrAiar+ Kin— -T,�*"YL [::A
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D =At'
EMTAIL�ED DtESCRIPTION OF WORK:
t Its �0 -11T MI-M I
•NSTRUCrIO011MA-1710
Additional work to be performed under this permit -check all that apply:,/]Fev�
_Mechanical _Gas Tank —Gas Piping —Shutters Windows/Doors
Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction:
Cost of Construction: $4614,EO
Sq. Ft. of First Floor:
Utilities: —Sewer _Septl� Building Height:
Pitch
OWNER/LMEE't7'.
CONTRACTOR:
Name
Address: il, FlIr
City:R-. I State: P.
Zip Code: sw- LA Fax:
Phone No.
E-Mail-,
Fill in fee simple Title Holder on next page (if different
from the Owner listed' above)
Name:
Company:QEkm
AodressAQ)Q
City: cgk�ap
Zip Code:
Phone No
E-Mail�
State or County Licens�
V-,, AAL
State: UL
Fax: I6-1)-T1Pr2) VIL
IT vaiue or construction is *z5uo or more, a RECORDED Notice of commencement is requirOd.
If value of HVAC is $7,500 or more, a RECORDIED Notice of Commencement is required.
I
�NZM
ARM
DESIGNER ENGINEER: X Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: - State: �^
zip: Phone
Zip: Pho e:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANI
: of Applicable
Name,
Name:
Address:
Address:
City:
City:
zip: Pho
Zip: Phone:
e
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to db 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 ' older to build the subject structure
which Is in conflict with any applicable Home Owners Association rules, bylaws or and coven nts that may restrict or prohibit such
structure, Please consult with your Home Owners Association and review your deed for any testrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all r spects, perform the work
In accordance with the approved plans, the Florida Building Codes and St. Lucie County Amerhdments,
The following building permit applications are exempt from undergoing a full concurrency relriew: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory usesto 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 COMME EMENT MUST BE RECORDED AND
- POSTED ON THE JOB BEE RE THE FIRST INSPECTION. IF YOtJjINTENO TO OBTAIN FINANCING, CONSULT
"ITH YOU ER OJ�/AN ATE RI1EY BEFORE RECORDING YOURAOTICE OFF COMMENCEMENT."
Signal a of Owner/ ssee/ o ractor as Agent for Owner
Si ture of Con actor/ icense Holder
STATE OF FLO
STATE OF FL
COUNTY OF
COUNTY OF m
The oing in t s acknowledg efore me
thi day of� 20 by
The rng i m t' s acknowledg efore me
thisday 20by
of
Name of person making st ment.
Name of person making tement.
Personally Known '� OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signatu f Notary Public- State of Florida)
(Signa r of Notary Pu lic- State of Florida }
Commission No " SdU SNELL
(
Notarypublic-State of Florida
*"'"�` Seal JULIESNELL
Commission No. 1.N �.(
, Not Public -State of Flo
;; = .3 Commission A GG t95877
' Commissfon RGG t95a77
r ughN
tiona,NotaryAssn.
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REVIEWS
FRO
PLANS
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REVIEW
REVIEW
COON ER
REVIEW
REVIEW
'REVIEW
REVIEW
DATE
RECEIVED
l
DATE
COMPLETED
KeV. 2/ // 19