HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a'`ab Permit Number.
:FFEB
ECEIVED
low 11.1,
Building Permit Applicatio ?020
Planning and DevelopmentServicesBuilding and Code Regulation DivisionST. LCount Permittin2300 Virginia Avenue,Fort Pierce FL 34982 — g
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT TYPE: .
PROPOSED INPROVEMENT LOCATION:
Address: J 7,95? 13P cta0+-M Z-AJ 'F-/. P wee , E/ 2Z/VY
PropertyTax ID#: .25 A S— .5'01 - 001 a Lot No.
Site Plan Name: Block No.
Project Name:
:DETAILED DESCRIPTION:OF WORK:
Remove- eXi,5ti ru-K 5hi;J�j le c � yAldei 1.4ymsr`, y411 ry m-e7a I � Ds?ipA+
R;Ci l f o4f. Rcplwc i ASS' 1'5ke:51eJ , D 1 -Ae R P-haer; 14, 1°A 11 5V Me-rA 1 ?X3
CONSTRUCTIO-N]NFORMATION:
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 —'Y//Z Pitch
Total Sq. Ft of Construction: y C) Sq.Ft.of First Floor: .510040
Cost of Construction:$ ®, t (�.'� Utilities: _Sewer _Septic Building Height:
OWN ER%LESSEE: CONTRACTOR:
Name J hpn7n s �SSr-hi14,/; Name: h 56.3'e Cj£•alws
Address: ,57g �fob- LiU Company: �, C'G,t�i/Ir�c7-ijy�iig
City: 771- A fee-e State: 1 Address: &//
Zip Code: Wi'qz Fax: City: in&YA H Jq 7-Ch!E I State-_r-_i
Phone No.- -277 2D- ^ ?S-i S Zip Code:1� Fax:
E-MSPLione No 5-6
Fill in fee simple Title Holder on nek4 page(if different E-Mail '7L®P cow
from the Owner listed above) State or County License
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 O ;Orr
our failure to Record a Notice of Commencement may result in your paying twice for
improvement o yoperty.A Notice of Commencement must be recorded and posted on the jobsite
before the f' st in. If you intend to obtain financing, consult with lender or an attorney before
commend ording your Notice of Commencement. 1-157
SignatuKe"oOwn-e-r/'re-ss-e—e7COTMmetor as Agent for Owner Sign 7turof Contractor/License Holder
STATE OF FLORIDA STAF FLORIDA
COUNTY OF S`f. LAA Gi Q COUNTY
The forgpjng instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ay of 20 0 bythis -Z_day of .r 13 20Z by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification V Personally Known OR Produced Identification
Type of Ida ificati nType of Identification
Produ lctvysG(i`P4 Qe- Produced }r C-6 jo-r
(Si na re of Notary Publ - e of Flory{ Y�s ignature of Notary P lic-Stated "'
c� NOTARY PUBLI
//�� NAPJIA'21EG N1
C mm ssion No. lTV o =STATE OF FL FDA DJ�I , GG 02-
%�Comm#GG05 9mmission No. �°� 'r,' MF�(PIFE � 20`0
•s• COM pec mbar io,
�NCEI Expires 11/3 /2020 ='; p= o,aearnmr�o+��p°b°`u'ae�";cars .
REVIEWS FR NT ZONING SUPERVISOR PLANS VEGETATI SEA TURTLE MANGROVE
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