HomeMy WebLinkAboutbluilding permitAll APPLIC LE I FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ..5 1 1 Ut-.tJ Permit Number: --------
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 _KJ __ ----
PERMITTYPE: Vlc.e
I?;]
Property Tax ID#: _______________________ _ Lot No. 31
BlockNo. ?_:5 Site Plan Name: --------------------
Project Name: _______________________________ _
Additional work to be performed under this perm it -check all that apply:
_Mechanical Gas Tank _ Gas Piping Shutters _ Windows/Doors
_ Electric _ Plumbing
Total Sq. Ft of Construction: J 1 t/
_ Sprinklers Generator Roof ____ Pitch
Sq. Ft. of First Floor: ________ _
Cost of Construction: $ -'.),~5_U_O ____ _ Utilities: _ Sewer _ Septic Building Height: ___ _
Name ~o" r ie.
Address:,.. q3 t1 J:L;f;lt:J Dr•
city: J {f\ gn ::&ac h
Zip Code: 3 '1 q f"J Fax:
Phone No.I? 72:J ftf-'-/ / h 2,,
State:fl..
E-Mail:, ______________ _
Fill in fee simple Title Holder on next page ( if different
from the owner listed above)
Company:, __ ,---------,---------
Address: 31 -f SW lM Ci,~ ·):CL tv
City: Pb J,..
7
State: fl.
Zip Code: 3 Y '18''1 Fax: _____ _
Phone No Q72.-) j' '6°'>' 3 7 id 1..,
E-Mail '.&01/:0l $2 :> e j,A-Vtw.c:.Ch'\
State or County License 3 3 L/ <g i-/ -_=-:,::;,.__,_,._..L... ____ _
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 Appl i cable 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 Countv makes no representation that is grantin g a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owner s As soci ation rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Associatio n and review your deed for any restrictions which may apply.
in consideration of the granting of this requested permit, I do hereb y ag ree that I will, in all respects, perform the work
in accordance with the approved plans, the Flori da Building Codes and St . Lucie County Amendments .
The following building permit appl ica t ion s are exemp t from l!nd,.,rgoing a full concurrency review : room additions,
accessory structures, swimming poo ls, f e11 ces, walls, sig;;,s. scc•,:o room s and accessory uses to another non-residential use
"WARNINC TO OWNER: YOUR FAILURE TO RiECrnti, ,'1, ff:€.rrn::1: OF COMMENCEMENT MAY RESULT IN YOUR PAYINC
TWICE FOR IMPROVEMENTS TO YOUR P~Oi"~;RT ,_ A ~OTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE AliSY ir~m•l:CTION . IF YOU INTEND TO OBTAIN FINANCINC, CONSULT
WITH YOUR LENDER OR AN "ORN BEFOH I:: !R!~COHDINC YOUR NOT CE OF COMMENCEMENT."
The forgoing instrument was acknowledged before me
this~ day of /'?4,Y:Cb , 2~ by
·1" 4q 1.H l.°-1,<.. f rOWn t.c....rt.0-
Name of person making statement.
Personally Known ,------\,,L°R Produced Identification __
Type of Identification
Produced __________ _
HS • ~ijt
2023
;.. \n.
STATE OF FLORIDA ,
COUNTY OF [Y'\Cl.C±:1 I'\
The f..9,r~o ing Instrument was acknowledged before me
this.,;&/_ day of t()o.cc_ fi . 2(Qpby
':,c...c..1 u-e \t--.L Prol.<.-\...,-z.~
Name of person making statement.
Personally Known --1,LoR Produced Identification __ _
Type of identification
Produced=------------
'--Sh_ c: f:J~
Co
da)
(Seal)
SUPERVISOR PL MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
REVIEW REVIEW