HomeMy WebLinkAbout5910 Bamboo Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Itlar(—H 31, r9ol c? Permit Number:
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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 x
PERMIT TYPE: 5 (D W &
PROPOSED IMPROVEMENT LOCATION: nn
Address: ��f l% !1 -- T_ig--
Property Tax ID #: . 2�' Q — (V 1, Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED`` DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
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: $ 32.1 (/ a d� Utilities: _ Sewer _ Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name -e A)Q,0Z-,'
Name: 6 S
C
Address: D 1�_
Company: C� o �
City: Pf CSZ-- State: FL
Zip Code:3`J Fax:
Address: S
City: _ 4 P'c4-, r State
Phone No.
Zip Code: C1 4 5 Fax: _ ---
Phone No c% 1
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mail i i\ C) r o (fit Y\
State or County License
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 $7,500 or more, a RECORDED Notice of Commencement is required.
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permic to ao rrre wur m dr3u I]Jll1G�w u� �•��•�-
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
strlucturin e. Please consult w with your Home Owners Association Association
drreview your deed for any restrictions which may aprohibit such
In consideration of the granting of this requested permit, I do hereby agree that 1 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 IMPROYEMENTS 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
NOTICE OF COMMENCEMENT."
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR
Signature of Owner/ Lessee/Co ortis Agen r Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY Of
COUNTY OF
-
The forgoing instrument was acknowledged before me
20�by
The forgoing instrument
this dLU
ayof - M
as a M1owl Z ged before me
Q�D by
this day of _ ,
bAS u t N � �.%�-S'
1 S
U� aV o n)�S
Name of person makin
statement.
e of person king tatem
Nammaent.
Personally Knowif-::� OR Produced Identification
Personally Known
OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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Si nature of Notary Pub -SIB f 540l�a V% blic State of Florida
1. g y
R
(Si ure of Notar
,�pRY Notary Public State of Florida
F1
No.
Desiree Flaxen
' My Corrf�us��Qn GG 240886
Commission No. Desiree 5@
y Commi ion 240888
Commission
ExpireS$�142i2o22
�a a� Expires 07122/2022
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
COUNTER
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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