HomeMy WebLinkAbout86 Las CostitasMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Building Permit Application
Planning ond Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort pierce FL 34992
Phone: (772) 462-L553 Fax: (772) 462-1578 Commercial Residential
Property Tax lD #:
Site Plan Name:
Lot No
Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION I N FORMATION :
Additional work to be performed under this permit - check all that apply:
Mechanical _ Gas Tank
_ Plumbing
_ Gas Piping
_ Sprinklers
_ Shutters _ Windows/Doors
_ Roof _ Pitch4tectric_ Generator
Total sq.Ft of Construction:Sq. Ft. of First Floor:
cost of Constructio ^,5 , O7Z Utilities: _Sewer _Septic Building Height:
lf value of construction is S2500 or more, a RECORDED Notice of Commencement is required.
lf value of HVAC is 57,500 or more, a RECORDED Notice of Commencement is required.
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PERMIT TYPE:
PRO POSED IM PROVEM ENT LOCATION:
OWNERILESSEE:
State:fu
Zip Code:
Phone No.
next page ( if different
from the Owner listed above)
Name: A-/ ftN N *urnr.t
_--Address: / 5 ,
citv: U efO E*f'o&' State: FL
Zip code: SJlb k ra",
PhoneNo^ ?27- (
State or County t-icense EC
AIIAPPLICABLE
b L*s (-.-s,.74s, -A.T--jAddress:
DESIGNER/ENGINEER: _ Not A-Fna;bte MORTGAGE COMPANY: _ Not Applicable
Name:
Address:City: State:
Zip: _Phone:
FEE SIMPLE TITLE HOLDER: __ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
OWNER/ CONTRACTOR AFFIDV!T: 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 subiect structurewhich is in conflict with any a'pplicable Home Owiers Asiociation rules, bvlaws or and covenants that mav restrict dr prohibit suchstructure. Please consult with your Home Owners Association and review'your deed for any restrictions r,ritricfr mayapply.
ln consideration of the granting of this requested permit, ldo hereby agree that lwill, 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 COMiIEIIICEIIIENT MAY
TWICE FOR IMPROYEMENTS TO YOUR PROPERTY. A NOTICE OF COMMETIICEMENT
RESULT IN YOUR PAYING
MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTTON. IF YOU INTEND TO AtN FilUANCING, CONSULT
WITH YOUR Atu RECORDING YOUR NOTICE
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLO
COUNTY OF (
The forgoing instrument was acknowledeed before me
this Z_atdiv or 47(t L ,zdz!_ av
Pu^v N*umN
Name of person making statement.
Personally Known V/ OR Produced ldentification
Type of ldentification
Produced
Commission No.
Public- State of Florida
Signatu re of Contradtor/License
STATE OF FLORIDA
The forgoing instrument was acknowledged before me
thisil*day ot APK t L ,20 zC, by
&t-A * lu,o.to*
Name of person making statement.
Personally Known | ' OR Produced ldentification
Type of ldentification
Produced-
Public- State of Florida )
MY CoMMISSIoN # GG 030145
COUNTER
SU PPLEM ENTAL CONSTRUCTION LI EN LAW I N FORMATION :
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Address:
City:
Zip: _ Phone:
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COUNTY OF