HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
s
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE:
Permit Number: D151A
RECEIVED
JAM 09 2020
Building Permit Application permittin,Oe a
St, LucieP rt
County
Commercial Residentialy
PROPOSED IMPROVEMENT LOCATION:
Address: /'Z'liy ze-'4 X
Property Tax ID'#: lid/ 36`` 6G�" �G�/3 l%GG- 7 Lot No.
Site Plan Name: ��!/�/%� Block No.
Project Name: G(
I
DETAILED DESCRIPTION OF WORK:
i
'i
CONSTRUCTION INFORMATION:
Jitional 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::'
Cost of Construction: $
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name %/��'n G�L�i! J2,
Name: "G%
Company: ''/ Y
Address: % �(G �j� %1//� A�> /�7//?jl a�
City: "ell, L/f% State: 16
Address: /91A- /U14Z e�r
Zip Code: Fax:
City: G 1-17', 1-wR
State:/C
Phone No. 77 l'6
Zip Code: N-(12 G Fax:
EtMail:
Phone No ls� �j'7,?
- 74;c'6
Fill in fee simple Title Holder on next page (if different
E-Mail
Vic
from the Owner listed above)
State or County License
it value or Construction is ,�cSuu or more, a MLOKL E) Notice of commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SbPPLEMENTAL:CONSTRUCTION LIEN LAW INFORMATION:
NEER: _ Not Appli
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
ress:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
ER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
Fy that no work or installation has commenced prior to the issuance of a permit.
ie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
ire. 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
1RNING 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
POSTE"N THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LEIIJ" OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE COMMENCEMENT."
of
as Agent for Owner
ATE OF UNTYOFORIDA��
The forgoing instrument was acknowledged before me
tliis ---5 day of%20 2'1/by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
,(Signature of Notary Public- State of F1 li'111111'
tEP�'E71�
Commission No. .:
ry PICHU ublEc (pf o
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W'4
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Commission N 43t98
My Comm. Expires Sep 8, 2022
i ►1nnry Assn.
Signature of'CotracUlf/License Holder
STATE OF FLORIDA ,/j�4 �j� /1
COUNTY OF `/ /5 /7
The for oing instruD nt was acknowledged before me
this day of ✓u%1 , 20 ZG by
Al� (17
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public -Sat
mICHE__E PREry
Commission No. o`�� POD : 8otary ,Public- tPg�° �F19 da
'sM<s ommfsston 8 8, 2022
ISF. my Comm. Expires Sep
—-., .i Nntary Assn.
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REVIEWS
ONING
SUPERVISOR
PLANS
VEGET
EA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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