HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICA LE INf O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: q I 1519,D Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
Commercial K Residential
PERMIT TYPE:
W i ndow h0mr �t I�ie�m�,rr1—
PROPOSED IMPROVEMENT LOCATION:
Address: n r -D(�V39ciS
Property Tax ID #: 0 5y J'- J o7,/- oMq - bbu -:- Lot No.
Site Plan Name: l 1-a-Uondom o I um Block No.
Project Name: J-(Nhj all ?ISldel)e (i
DETAILED DESCRIPTION OF WORK:
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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
Total Sq. Ft of Construction:
Cost of Construction: $ 1 ,
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name m r
Name: "
Address: 910114D DIr -tt so
Company: � w 3
City: _JAljen_bu',i, State: �L
Zip Code: Fax:
Phone No. 2 • ®®
E -Mail:
Address:% SL DMC f4vi
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City: SIT State:
Zip Code: -y4 r Fax: wl• 2�U- N tal
Phone No lqq-- ITU - CA450,
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail ?WfAi S. 41 aS iPfbS gft1a 11 M1
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State or County License 19 3U,3
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
Name:
MORTGAGE COMPANY: _ 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 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�(5 Owner/ Lessee/Contractor as Agent for Owner I Signature of C6n`fractor/Licens4 Holder
STATE OF FLORSTATE OF FLORIDA
COUNTY OF kgn COUNTY OF WAA11h'1
The fo going instrupent was acknowled d before me
this day of 1'f,L'►1 20 by
�c� v► C� �aAwl
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
( l.{1 °i
(Signature of Notary Public-Sta a of Florida )
Commission No. M -3Lf�� (Seal)
The fg-rgoing instru ent was acknowledged before me
this day of 202,t':by
d \_ ercA dR_,
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
dLAA,
(Signature of Notary Public- tate of Florida )
Commission No.cG Z3L[6U, + (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
BRENDALOPER
illy COMMISSION # GG 234007
Undet fdors
;� ":�!'"!,•:, BRENDA LOPER
A FAY COtvt!viISSION # GG 234007
EXPIRES: July 1, 2072