HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST 82 ewJMPLETED FOR APPLICATION TO BE ACLcriED 1� (� �2
Date: Permit Number: (2(p CS, QoG
a
--- 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:
F46a A)
Property Tax ID #:
/414- 704 - `C ool
- OODg
Lot No.
9
Site Plan Name:
Quorrh7S fs(A'Ajb
JE�/Lx/g
Block No.
4
Project Name: A(3QOA, -J
Poo L / 6
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank
_ Electric _ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $
—Gas Piping
_ Sprinklers
l5-700,00
Shutters
Generator
Sq. Ft. of First Floor: _
Utilities: _Sewer _Septic
Name ✓FNF7-7AtJ A-DMlnt ISVAMOO LLC,
Address: f4qf� 10r. RAGL6(Z Si
City: M (A M 1 '' " State: FL
Zip Code: 33 (�{ �i F.ax:
PhoneNo. J�12.�pQZ}�igz{, --- ..---
.._.,
E-Mail: 'Vo,(,+e%iA(,7T_l '1r10hs�PS• (°_am
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Windows/Doors
Roof Pitch
Building Height:
Name: A4W,4N0'D l2CTOS TVI-,510o
Company:'tSPTA2 C01J6772-C7-t4a/J L-
Address: /03(no 60 40 c57-
City: ml-AwbI State: F'L
Zip Code: Fax:
Phone No —79 0Ll- —3S55-
E-Mail retie-5-Wedocre ya "O, 0.0'-77
State or County License 311zf 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.
00f�� 1
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 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
Signature of Contr ctor/License Holder
STATE OF FLORIDA • 'tom)
STATE OF FLORIDA
COUNTY 0. �CI�C�
COUNTY OFF , a
The for oing instrument was acknowledged before me
The f rgoing instrument was acknowled d before me
�
this day of sQ 17� -� 2d� by
this day of 2� by
V \ C.t r Qy-w Q Q
l Rn m' mr"p _n rr}'o
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification _V_
Personally Known OR Produced Identification�'
Type of Id en fication
Type of Identification
Produced M1 '�\�_
Produced
014
# GG 2
CommiseloOANNn
EXPIRES: August 20
2022
s�
Signature of Notary Public- State of Flo ,
(Si tur :ai.Ala_
[ASHAHNAINGRAM•RAHMING
Commission No�� (Seal)
2 J��
Commission;j$o.. !AycGMMISSION#GG275060(S. I)
. iR15f•.,it ^?:PIKES: December 20, T"'7
. :e sA 11im Notary Public [Ink .e.:
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Rev. Z///19