HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Ir"I. �{ W-
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: Moan ICa l
', MEN
Address h—ng artemr ictr C L r
Property Tax ID #: J� �� —100 ��1a� -97 Lot No. —
Site Plan Name: Block No.
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Project Name: Vi19, vA i �i' 1
LEA
V_e r 1k - 1
10KW
U-PV1YIDY, Cft% H- QL6_0 ML14A P 1-0[p0
Additional 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: Sq. Ft. of First Floor:
G n
_<� Cost of Construction: $ Utilities: Sewer` Septic Building Height:
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Name 'W—knV I
Name: JOSE RAMIREZ
Address: `1-14S tI r 5 r
Company: EAST COAST MECHANICAL
City: Por_ 'St tuoi�' StateTL_
Address:1500 N HIGH RIDGE RD
Zip Code: 3W0i8CP Fax:
City: BOYNTON BEACH State: FL
Phone No. 1_1a 4Ws --n95
Zip Code: 33426 Fax: 561-493-2701
E-Mail:
Phone No 561-586-3739 EXT 2020
Fill in fee simple Title Holder on next page (if different
E-Mail PERMITS@ECMSERVICECOM
from the Owner listed above)
State or County License CAC036812
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: _ 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 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
wrru vrn io i FmnFn nn AN ATTnomFY RFFnRF RF[ inipin ir. YntiR NATIrF AF rnmMFNCFMFNT_"
Signature o 0 er/ Lessee/Contr for ` Agent for Owner
Signatur o ontractor/License of
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF PALM BEACH
COUNTY OF PALM BEACH
The forgoing instrument was acknowledged before me
The for oing instrument was acknowledged before me
this 10day of � 20 W by
this Is day of FINO , 20 70 by
JOSE RAMIREZ
JOSE RAMIREZ
Name of person making statement.
Name of person making statement.
Personally Known X OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification Y GILLIAN CHUCK
Produced
Produced NOTARYPUBLIC
a STATE OF FLORID
C FF972357
eUCK �` Tres 4R12C20
(Sign ture of Notary Public- State of )
(Si ature of Notary Public- State of Florida )
NOTARY PUBLIC
Commission No. a STATE OF FLORI
Commission No. (Seal)
Cw vO FF972357
41712020
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