HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED s7
Date: �a Permit Number: o2p X ,,/07' 621 •/k
IRS
REIM,
Building Permit Application FEB 6 2020
Planning and Development Services
Building and Code Regulation Division Permitting Departmen
2300 Virginia Avenue,Fort Pierce FL 34982 C LI.I I Cu nty, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Res ''
PERMIT TYPE:
MIM E11.1
Address: 0�
Property Tax ID#: �7r��5�6 �� �� Lot No.
Site Plan Name: Block No.
Project Name:
X
�ai�STRUCT iCN 1 >✓OR T }f : y° e
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric c,lumbing —Sprinklers —Generator —Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost'of Construction:$ t'�O� Utilities: _Sewer Septic Building Height:
Name C9rrol� 5'f�G� o LLc ' pName �J!lJ!�.'
Address: bo f•���: `off ��✓D Company:,'
City: State:_ Address 14—/'0 f
Zip Coder Fax: City: a� ���' ' ... State:
Phone No. Zip Code: �9���65L Fax:
E-Mail: Phone No ��cG �F/5��� &
Fill in fee simple Title Holder on next page(if different E-Mail /V,-4,4O /SSG c
from the Owner listed above) tate r County License
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. GGG
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. 0
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 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_restrictionswhich 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."
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA /
COUNTY OF S� �ritryi' COUNTY OF to 0/ 0 LzCG
The forgoing instrument was acknowledged before me The for oing instrumentt as acknowledged before me
this 6 day of Z�j6 202v by this day of (� 202D by
Name of person making statement. V Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
77
�p"R' NKNOLAS MMOO
A. tate of Florida
001A5 MITT00 mmiwon#GG 922464
+`my Comm,Expires Oct 12.202?
e o orida a ; .
Signature of Not tatbr G 922464 (Signature of otary FBmbdia�t�iteg44�d�#UiP�'
'.°F .• My Comm.Expires Oct 21,2023
Commission No. 9ondedthraughNat( NotaryAsso, Commission No. (Seal)
REVIEWS. FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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