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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 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: J„^ a o�AA cwl Permit Number: o(O©l — 0531 Building Permit Application Commercial Residential Address: 30t /y, C. Prlyna (r;ssc, 6WA Property Tax ID #: — -- Lot No. Site Plan Name: Project Name: C V5 N�5 � - .530. (00-1C Ceel.te n tmt fur lfke 501r, caw=ec..,j plc, vn c r n C_ E R z /7 0d;10 Block No. 103 Additional work to be performed under this permit —check all that apply: 2!IVl✓✓echanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Electric Total Sq. Ft,of Construction: Plumbing _ Sprinklers Cost of Construction: $ ✓ 000 Name 5reveA _ Generator _ Roof Pitch Sq. Ft. of First Floor: Utilities: —Sewer —Septic Building Height: Address: k\ 1?ersely2to..�C sr, City: /Kr P\ew jaw r State: 5 1- Zip Code: 2,9,441( Fax: Phone No. « 865 —3552. E-Mail:_ i\\¢:Maw �i Sv�o'LAeo. Lv Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name:_ Company: Address: Z6'(OD .Su41 Fretl rY City: 4arl.,,ya. a State: Zip Code: tf WC, Fax: ZW-U7. 377 6, Phone No E-Mail =6 a Co. State or County License CAG 1919015 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 MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone:_ _ Not Applicable BONDING COMPANY: .Name: Address: City: Zip: Phon( Not Applicable OWNER/ CONTRACTOR AFFIDVIT: Annrrntinn is hPrPhv marls tn nhtiin n normit to rin the ,.,,,r - nnri inctniintinn mc inriirmt-4 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, 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 RFFnRE RFrnnniNr. vnuR NnTirF nF rnmmFNrFMFINT „ nature wner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder r6UrrK -C��` � STATE OF STATE OF FLORIDA COUNTY OF COUNTY OF Nilm 8-eg c4->I The fgrgping instrument was acknowledged before me The forgoing instrument was acknowledged before me his f tday of414 20 v P by this old- day of jgri. , 20U by Name f per o) making —aa ent. Name of person making statement. Personally Known OR Produced Identification Personally Known _)6 OR Produced Identification Type of Identification Type of Identification Produced Produced .•``'� ANN ••,,,� p,RY •• I I (Signature Nota Public-S eQf i , I., ZULL WLYNNUARIY bign ure of Notary Public- Sta i da )_ � Lcom, Commission No. .Z09/ 29 = Commission No. C7C-►23'�b`rt`1 �fogr(S�,� OF REVIEWS FRONTNrV4W VISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER R���►``FZEVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED' DATE COMPLETED