HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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:
PROPOSE► iM'PRRAEMENT LOCATION
Address: x-1309 Gy .CSW oe J Aki
Property Tax ID#: 2 y �7(a _ ��( /)Oq9 ono TR Lot No.
Site Plan Name: Block No. S
Project Name:
DETAILED DE�SC•R PTION OF WORK:
f C� (TL�n v� .S t11,_+C�L�-� Lr� ��w P�-i � •Q,�� �s,—�sic. ,ate,c�
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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 _Generator Roof y I Z. Pitch
Total Sq. Ft of Construction: 2 0oo Sq. Ft. of First Floor:
Cost of Construction:$ 6,60Cp• Utilities: _Sewer _Septic Building Height: ovz_
OWNER/LESSEE: CONTRACTOR:
Name irt_.s�� [�6��„� Name: S j e\JG ,3 CA516&x-”Sin Q
Address: \dZp 1.5 . `[S - St- Company:_(w�LG,.�Gu.r�t, �c wiC� cLc
City: C-t Pi e=a2� State:FL Address: 3�L'1 t GLr-A,a 7L-Yx_ A_Vr✓
Zip Code: 3L[J it`d Fax: City: 10(e Z ec 7 State: L
Phone No. $U 1 -7 Lt-1(o Zip Code:. 3`"tq K2_ Fax: -72?_ -'-L6(-6,1-tS'-
E-Mail: Phone No T?-2
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License_ 55-5-73'/ 16Z 8-5
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.
UPPLEME TAL CONSTRUCTION IE�N LAW IN �• RMA ION:
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: Not Applicable
Name: 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 TH SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO IN FINANCING, CONSULT
WITH YOLIRkENDER O TTORNEY BEFORE RECORDING YOUR NOTI OMMENCEMENT."
Signature of Owner essee/Contractor as Agent for Owner nature of Contractor/License
STATE OF FLORID STATE OF FLORI A_
COUNTY OF— 5� LVb-P COUNTY OF Lu
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of VVIC�rC�l 20y this day of N/lC��h ,20y
(54-tve/) CCI 1`lN 6�eIlC'4
ab
\nya
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
1MENEZ E
Fignaturd,of Notary Pu ' - G;id�p�aPy Ru li .State of Flor a( i nature of Notary Pubfi ate o or da) C�TME. ]2023
(:pmmission#GG 921213 eQr ae Notary Public.State o 1 Commission No. -1�" (5?�'60mexpires WOW 8,2 `� mmission No. �� _ e I) Commission#Gct
My comm.expires Octo er
REVIEWS FRONT. ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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