HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCFNIiD �
Date: Permit Number:ayv(�j CL
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:
Address: _ 442Ho IJ #Wi AM
PropertyTaxlD#: l4l'q-770,q- "S- 000/ Lot No. 7-
Site Plan Name: C 05�6WS /aG4ti1D Block No.
Project Name: Ae-2U,4Vl.S'Tr1-
r/�
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
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ a 000, 09) Utilities: -Sewer _Septic Building Height:
Name Vt NET/Q� AD/✓Lmm-MA-770A7 /,
Address: -7`% <vi FtAGLe'7R- 57,
City: AMANI 1 _. State: FL
ZipCodei, 3-6144 Fax: I
Phone No. -M-) Sla- 4484
E-Mail: VDY {eqq i011 �DYne9. (°nm
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: AIWAK)DO 25VOS W05DO
Pitch
Company: AQ-TA iZ CXOSMO V-i 1O/J LA-e
Address: 13360 SUD 40 SST,
City: MUA41 State:ffL
Zip Code: 551 ::FS Fax:
Phone No -T9(11- J4` -'50 55
rr E-Mail e%�es TUl-2G,c>a(RYako0, (?49,-Y1
State or County License Sit ± )
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.
DESIGNE
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:_
Address:
Address:
City:
State:
City:
Zip: Phone
Zip:
Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable I BONDING COMPANY: _Not Applicable
Address:
Zip:
Address:
City:_
Zip:
Phone:
OWNER/ CONTRACTOR AFFIDAVIT: 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."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Si nature of Contra for/License Holder
STATE OF FLORIDA ^e flp
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The Qrgoing instrument was acknowledged before me
The fp�going instrument was acknowledged before me
this � day of < P (Di 20� by
thist5 day of.2�0_ by
V l r
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification,
Personally Known OR Produced Identification
Type of Iden . 'catio
♦o';".ay,.
Type of Identification
Pro ced
Produced
/� COMDqN
le
t / , g�PINFS, GG750
(Si ure of Notary Public- Staatte of Florida) oft ZO?y
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Sig at re of Notary Publ' - State of Florida
Commission No. C1 �U_k (Seal)
Commission No. :;M':Pu;••�eSF1AFl
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REVIEWS
FRONT
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SUPERVISOR
PLANS
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COUNTER
REVIEW
REVIEW
REVIEW
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Rom%(
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19