HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Perrnit Number:
m I M-, ;T . . . . . .
10
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
PERMITTYPE: N CAMOV
PROPOSED IMPROVEMENT LOCATION. -
Address: 62,qlel
PropertyTaxlD#:
Lot No.
Site Plan Name. — Mal?& i
Block No.
Project Name:
[_�ETAILED DESCRIPTION OF WORK:
66Ln&L� Alfe - HIS Vd _36At" 12 T
[�CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_��echanical — Gas Tank — Gas Piping — Shutters
— Electric — Plumbing — Sprinklers
Total Sq. Ft of Construction:
Cost of Construction:$ ,, J�, ld)�"
Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: Alldm
A d d r e CJM E
Company: A6 L,(Jzd6
City: '70/212 State: A/
Zip Code: NqO' Fax:
Address: J
_6_113 SE 1R77&1?6P Cr
City: ', si"-� State:-F—/
Phone No._3�L_ 53-tv- /155s�
Zip Code: Tql?lq Fax:
E - M a i L AL46n 11arl-, /Ad 01/974
Phone No 57ZL-
E-Mail-a&2I fgwAv&�_ LA?_/� I "W
V
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License mraf 'ell,11-0
IT value of construction is 52500 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/ENG [NEER: Not Applicable
Name:
MORTGAGE CO�iPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: . .... . .. . .. ...... ............ State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 certifV 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 bylaws
rules, 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-residentiai 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 F1 -1 NG,MNSU1
WITH YOUR LENDER OR AN ATTQRNE`II`,J3EFO"PERECO DING YOUR NOTICE OF COMMENCEMENT."
Sign�t&�-of Owner/ Les'see/Con-tractor as Agent for Own�r—
S ign auffe-of-e6ntra ct 0 rATc e n der ---
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF &�2 &IM
The fpcgoing instrumentwas acknowledged before me
tIr ZIE day of 209
�U by
I
The forgoing instr t was acknowledged before me
this X4day of 20)1�_ by
Name of person making statement.
Name of person making itatement.
Personally Known L�1� OR Produced Identification
Type of Identification
Personally Known OR Produced Identification
Type of Identification
Produced
Produced
7
(signature of bil-C-09" qfiftw
A COMOOGG 48177
.n
Commission 16. C.-
IF J,,,Ia 023
onded Thty Aaron Notay
(Signa6�e PuM*MWF.fflw
Mn
Comm.10348977
Commissi� PiA7� V no 26, 20131)
Bonded T�hru Ann Notary
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev. Z/7/19
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