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HomeMy WebLinkAboutNoyes AppII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Commercial Residential ✓ Phone: (772) 462-'1553 Fax: (772) 462-1578 � PERMIT TYPE; Address: lqD Ntvi,l !^�k ti(Srm( 4c, A�1 A i Vtl 3'4 Property Tax ID #: -1 � ab Lot No. Block No. � Site Plan Name:9.Y�S �1Q. twirl _ Project Name: — �P,NSTRUCT:(A, !NFORMATIO 0.1 Additional work to be performed under this permit - check all that apply: j `� Windows/Doors _Mechanical _ Gas Tank _ Gas Piping , Shutters _ Electric _ Plumbing _ Sprinklers _ Generator — Roof Pitch Total Sq, F` c` Construction: Sq. Ft. of First Floor: Cost of Construction: $ _ 6, 0 0• U0 __._ Utilities: ' Sewer _ Septic Building Height: _ .. -- CONTRACTM Name �r,Q D cY rlOi%$ Name ICi1f1Q �.t,(�reS Company: lu k &TW IC of P�(¢�Icc4 fk,A �Bbow�,,r�� Address: li-}0 �ItI�ID� Cr,- — � D�,"�" Cite: A-17(111 -0q- ��LIkNND State: eLL Address: 110 B 1_QMak4U*- Df' Zip Code: Fax: City: h1(1f4"� r�A2•YLLGG� Stater _�4g1il, G Phone No. rJ(D1-_ 31-1- (9�iL�3 Zip Code: 32;gbl Fax: 3x-- r' 4) Phone No -7-7 a- 337- 4110 E Fill in fee simple Title Holder on next page if different E-Mail 9LJA.M ?rP��"Stan r �t�C•�'1R.-�' fram the Owner listed above) State or County License a 01'15f if value of construction is $2500 or more, a RECORDED Notice of Commencement is required. If value of HVAC is y7,500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: Name - Address: City: Zip: --- _ - -- Phone_ FEF .SIMPLE TITLE HOLDER: Name: Address:—� City: _ Zip: _ Phone: — _ Not Applicable State ___ Not Applicable MORTGAGE COMPANY: — Not Applicable Name: Address: City: State: _ Zip: Phone: BONDING COMPANY: Not Applicable Name: Address - City: Zip: Phone: )WNER/ 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. A. Lucie :oil tv snake; no rep!esentation that is granting a permit vviil auihorize the permit holder to build the subject structure rvhich i�, in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such ;tructure Picas? consult with your Home Owners Association and review your deed for any restrictions which may apply. consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. e following building permit applications are exempt from undergoing a full concurrency review: room additions, �s,:or; stncct.IrE s, sw'irming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use YARNING TO OWNER: YOUR (FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING 'TWI';E !FOP LMPROVEMENTS TO YOUR PROPERTY. A RNOTPCE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT ..,,,-ti v ns,n : Cw4%rU ho AN A•r•rnR!y! y LaFFnrsF RFiropniNlG vouR NOTICE OF COMMENCEMENT." E'b Signature of Cwner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder S,A TE ::F FL'-�'A STATL OF FLOPMAI COUNTY ems= ���--- --- — COUN FY OF The Forg(wi - it stri Ir4enc was acRhowieciged uefore me l Ot (oigoing instrument was acknowledged before me this day or 202D by this _�day of 20_26by Name of person rral<ing statement. Name of person making statement. Pertzonaliv Knowr• _ ___ OR Produced Identification Personally Known OR Produced Identification Type oi} icient-ficat.r. Y iype or identification Prc,du" Produce • ignature ofXotPublicState o orida) Ignature of N Public- State of Florida ) Cornrnission+Seal CommisSionNo./0!'9 7U ��5 ) l =o� ��)4PX11r:,A1 Publicat n __— JAY hMNotary Public State of FI ri_da commission `T.- --- ey ntonelli cola 2 REVIEWS FRONT Eyp i 1 29710LA VEGETATION SEA T COUNTER V R VI REVIEW REVIEW DATE RECEIVED -- DATE 2/7/1.9