HomeMy WebLinkAboutApplication garage doorAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
0% 0-3-FAMP
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
PERMIT TYPE: club,GE D009, j
PROPOSED IMPROVEMENT LOCATION: _ p�
Address: V(05� V I> �/� %" T i"k
Property Tax ID #: 13 LJ W I- 00-� C � _i- 0o - 5 Lot No.—iQ -
Site Plan Name: TkWJM uLt,
t A�li Block No.
Project Name: Im A 6 NAB
DETAILED DESCRIPTION OF WORK:
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: $ _� Utilities: _Sewer __Septic
KI
_ Windows/Doors
Roof Pitch
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name �4Z0 �
Name: SCAR. rLpZ I g 1
2 L
Company: �:tCt1T1L.E. WRp
Address:
City; t• (� State E
Address: 310 rURT1--S Co
Zip Code: Fa
0 � �
City: �T A►L.M BCz4CH State:
334 11 Fax:.
Phone No. I, •
Zip Code:
�
15 5 �
E-Mail:
Phone No
E-Mail Vw h
rfic,
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License
_s
If value of Construction is $2500 or more, a KtLUKUCU [VOULL U+ LVtntttcuactnc�tc � .�y+�..��•
if value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
SIGNER/ENGINEER: _ Not Applicable
Nam
ft,TGAGE COMPANY: _ Not Applicable
Name.
Address:
Address:
City: State:
Zip: ne
City: State:
Zip: Ph
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 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."
Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA --
COUNTY OF��` l) Anc� . WIN,
The f oing i str ent� as acknowledg d before me
this day i('A-a 20 by
AJ � e/a /3/� a 4)
Name of person Makin atement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature oP Votary Public- State
Oxon F
Signature of Contractor/ 'cerise Holder
STATE OF FLI
COUNTY OF f-ISL.M jCJ7 zp4
The fo oing in tr tr1�ent was acknowledged before me
this day of . L' 20 ` O by
r
tf 02A Xk
Name of person making statement.
Personally Known � OR Produced Identification
Type of Identification
Produced
C- Jl4otarvv Publ'c StetZ of Florida
Marybell Martinez
Commission No r �� ' (Seal) Commission No. I My commission 60.100975
N w xpiros 10/24/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
PyNotary Public State of Fiords? Us Marybell Martinez
OF