HomeMy WebLinkAboutBuilding PermitII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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:
Building Permit Application
-TIOCATION'
Commercial Residential
0
Address: �i �g�
Property Tax ID #: 35 Lot No.
Site Plan Name: , Block No. _
Project Name: IV�t �"� �1 �' h A "
Additional work to be performed under this permit — check all that apply:
Mechanical _ Gas Tank Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: ,__ Sq. Ft. of First Floor:
Cost of Construction: $ 11915. Utilities: _ Sewer _ Septic
VI/Windows/Doors
Roof P rtch
Building Height:
NameAlp l f Cant Or4112AnW
Name:
Address:314a 46 WI" IWW
r-
Company: MA 94r1i'rXSG
a( T. (CV 'dL W RWS�d'0trML
City: �g ' �A(Lit'-
State:
Address: /to 13 'rQ Mik44*-
Dar, bMr
Zip Code: g�_ Fax:
City:
26tcG�, State:_]6L
Phone No. o G 1:—, 34pI
Zip Code: 3a931
Fax: 3x�?i�'`�a�_
E-i'✓iaii.
Phorie No -77a-33`1' 4`t?0
_
Fill in fee simple Title Holder on next page ( if different
E-Mail1_���(SfdV�rieD�
I State or County License
Q0/151-'
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is 17,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip:Phone—.-----
FEE SIMPLE TITLEHOLDER: —_ Not Applicable
Name:
Address: --
City:!_
Zip: _ Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: ---__— Phone:.
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
— Not Applicable
State:
^Not Applicable
)WNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work of installation has commenced prior to the issuance of a permit.
>t. Lucir_ ;'-o4nty Makc-.; no representation that Is granting a permit vviil auihorize the permit holder to build the subject structure
vhich is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohlb;t such
,truct! ire Pleas? consult with your Home Owners Association and review your deed for any restrictions which may apply.
n consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
n accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
he following building permit applications are exempt from undergoing a full concurrency review: room additions,
cc�s,or;- structures, sWirtrning 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
TWIl FOP tMPROVEMENTS TO YOUR PROPERTY. A NOTWE OF COMMENCEMENT MUST BE RECORDED AND
POS.'TED ON TIIE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WIVH YOL R LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
�Gca.uY�AaA- —tore occnnv�t�t�--er
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contrac or/License Holder
STATE :;F FL(A
COUNTY
The Forgoin8 ir.st,wii(en� was acknowieoged oefure me
this day or _. P� , 2020 by
Name of person making statement
Nersonal,V Knnwr, OR Produced Identification
Type of11
ident fi,:at.c --
Predur0d. _
Signature of Pary Publi ate of Florida ;
GG %U
Cornmission h .
y� Notary Public State of Florida
Ashley M Antonelli
5TATL OF FLO DA
COUN FY OF )T_A __.Ad
1 ciu rorgoing instrument was acknowledged efore me
this day of � .h 20by
is nr)l I I A,
Name of person making statement.
Personally Known OR Produced Identification
type or identification
Produ(,P{1--.
ature of N ary Public- Sfafe of Florida
w
nis>ion No. 76 _ 3P` '�Se(),. tat Of
M ,ern•. • - ' G 1
REVIEWS FRONT
NS
VEGETATION
SEAT L
"MIG P. E
COUNTER E
E
IEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED_
DATE
—
2/7/19