HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO 1MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 2f,
Date: I►l �.� ` . �42-6 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 'x
PERMIT TYPE:
FIRIT. DI' RI NT ONwd O
Address:
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Property Tax ID#: Lot No.
Site Plan Name: (�r�C�f�I Q S/Y Block No.
Project Name: C�N��'I �� DP,I 5 0) ��UI
DE ICED DESCRIPTION U�WORK:
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6 6 c SSS — w-Aes Co NL '51& w
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CON T UCTIQN : 111
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _PlumbingfTZ
nkl _Generator Roof Pitch
�LTotal Sq. Ft of Construction: U C� I Sq. Ft. of First Floor:
/
Cost of Construction:$ L O D b •0 0 Utilities: —Sewer _Septic Building Height:
NOM N'5R 111 R: /t C NTRACTQR
Name.` :Name: ?(J I I
Address: 10 1 SbCompany:
City: State: Address:
Zip Code: L.� Fax: City:'. State:
Phone No. 3 5c> 3 C '71 Zip Code:` Fax:
E-Mail: Ke,7) Phon.e No
Fill in fee simple Title Holder on next page(if different E'Mail'
from the Owner listed above) State'or',County License
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.
r
UR MWEMM(OMMU97M LIEN M.W INFOaAT O
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 Applicable BONDING COMPANY: \N pplicable
Name:9w" L- Mwr(2 Name:
Address: QP �3 — Address:
City: f erc_41 City:
Zip: ;qqq Phone: 33Y y5b34-7zip: 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 thepermit 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
POMYUR
TH JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WIT EN R OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature o Owner essee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORID STATE OF.FLORIDA
COUNTY OFCOUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this J(,�_day of ✓aQC:.; 20Z�by this day of 20_ by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
IM
(Signature of Notary Public- ate of Tloricla) Signature of Notary Public=State of Florida)
Commission No. (Seal) 3 ommission No. (Seal)
m�+3�
y 0
REVIEWS FRONT ZONING SUP g� LANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW R / T VIEW REVIEW REVIEW REVIEW
DATE N m d
RECEIVED Nx C0*4
DATE — m
COMPLETED
ev. 2/7/19