HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED —1
Date: :3 I 1 120ay Permit Number:
Eation
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'' Building Permit AppliPlanning and DevelopmentServices Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE: .
PROPOSED fMPROUEM ANT LOCATION:
Address: L'31z � y C'�V�q l�♦�� C� VV J -2
Property Tax ID#: drQ_X dbo -4 Lot No. 2
Site Plan Name: ��11 nn Block No. -L
Project Name: mit Ct V,._ G W ov
DETAI ED=CR FP m OF WORK: l
b00, I� C%t.�� 7 1 C
,33
CONSTRUCTION IN'FORMA ION:
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:
Cost of Construction:$ ' (000 Utilities: —Sewer —Septic Building Height:
OWNf R/LESSEE: ITIRTANITN"RE!1111111111111
Name l'21A P If- k V 1, Name:
Address: y�3& SEi A-ya✓l6c.CIL/P Company:
City: �90y - State: L Address:
Zip Coder Fax: City: State:
Phone No. (--7 -72- 221— (Z3 C/ y Zip Code: Fax:
E-Mail: boo• J Phone No
Fill in ftre simple Title Holder on next page(if different E-Mail
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.
SU R M ANT L CONSTRUCTION L N LAW f 'C!1" NE :
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
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signatur of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STAT OF FLORIDA STATE OF FLORIDA
• COUNTY OF Sk. �.v c'k� COUNTY OF
The forgoing instrument was acknowledge before me The forgoing instrument was acknowledged before me
this k_day of `nt�Q{ \\ ,20a by this day of 20_ by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced ° V Produced
4t•`
(Signat re o Notary�,v��t"fta'te oeriat�j v° E of Notary Public-State of Florida)
4' GO�PJIfSS10R#GG 04202-3 I (Signature
Commission No ae- EXPIFRcember 16ZO�Oter
gondedYhNNo N
publicUnderNn �'. Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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