HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFOMUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 '� !• Permit Number:
RE "EIVE
JOE- E _
Building Permit ApplicatLPermitti
N 2 7 2020
Planning and Development Services
Building and Code Regulation Division ng Departme t
2300 Virginia.Avenue,.Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resi County, FL
PERMIT TYPE: (`)CCA -K C o
PROP•SED I' P.ROUEME T LOCATION. G�
Address: 3� 6 , �� Kr,•• S ff' ic;titer c4
Property Tax ID#: l.�,o – J Q� [��� Lot No.
Site Plan Name: Block No.
Project Name:
DETAIIF IlDMalP OPTIONOE WORK: �
Zvd &rnp tv-r Mekv 00 z- aLe
z e ?L '2-7-z
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping —Shutters _Windows/Doors
VElectric _Plumbing " _Sprinklers _Generator _Roof ;,Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ C, /U�,� Utilities: Sewer —Septic Building Height:
OWNER/LESSEE. _ CONTRAC 100,R:
Name C .�e:��y7rnYo� ,�ne,��res GCC Name: �,., � rlr3:r•�
Address-_ %Jr h o��µl �yT., - Company
Cityy17ae r/ -` State Address ,,,pp
Zip CO(�2:! �..cl`.t by } ay FAX•: ; f �» 'i Cltyt%'� r iJt'CyL� _ 1State:
Phone{bio ,1: r f f.,'-n 1 n t'' Zip Code:`JZCj6G.. Fax;'
E-Mail: ,;.. _w. :? Phone No -7:z 11") 1 </:.: ,;'3
Fill in fee simple Title Holder on next page(if different E-Mail T)1 , [y!r'+
from the Owner listed above) State or County License ��C I .� OJ�(Z- Z
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.
SUPPLEMEN AL C�NSTRaUCTION LIE LA tNFURMaTI(�?
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: 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 thepermit 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,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."
G.. ✓I
Signatur f Owner/Lessee/Contractor as Agent for Owner 'Signat a of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF �4
COUNTY OFA 9
The forgoing instru t was acknowledged before me The forgoing'nstr ent was acknowledged before me
this��day of 2Q�by thi �day of 2QV by
N erson making statement. of erson making statement.
Personally Known OR Produced Identification/ Personally Known OR Produced Identification
Type of d1 ' cation Type of en ' '�C tion
Produce Produced
e
(Signature of Vary Public-;State o �„Ioa' (Sign ure of Not Public-State of Florida
Commission No. �si!!S :••, � i7 62023 Commission N ''��•."•'• 8' 17
•p EXP1R'`S: �,�ecwr►t�s -.f.:' EXpMm l►6.2023
• 11ru
REVIEWS ZONING SUPERVISOR PLANS VE UK ILL MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19