HomeMy WebLinkAboutBuilding Permit ApplicationvA
All APPLICABLE INFO MUST BE CO...,�ETED FOR APPLICATION TO BE ACCEPTI` -- LA t'�
Date: 3 i� - ZO Permit Number: �J J' OI q
ERECEIVED
Building Permit Applicatio
Planning and Development Services 0
Building and Code Regulation Division2300 Virginia Avenue, Fort Pierce FL 34982 rmitting
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMITTYPE: I-P CA)S li9NK !w,5'f4w4-rl61v
PROPOSED IMPROVEMENT LOCATION:_ ,5E; , .SiTC pLAN_
Address: -7'aZ3 r►)e6ng- WAY PST S-r, kl/06 FL JY9606
PropertyTaxlD#:2,322 Le7r)• 0040• 000• Lot No. 35
Site Plan Name: F /MOTfso Block No.
Project Name:
6 O
DETAILED DESCRIPTION OF WORK: I
2,v 6f R ,
CONSTRUCTION INFORMATION:
646
Al
Additional work to be performed under this permit- check all that apply:
_Mechanical ✓Gas Tank t�GasPiping _Shutters —Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: �A Sq. Ft. of First Floor: A116
Cost of Construction: $ Z9 Cl 9 Utilities: ✓Sewer _Septic Building Height: N/fl
'OWNER/LESSEE:
CONTRACTOR:
Name JANG%-7/M07-E0
Name: bFAA! ScHNcrbER—
Address: -1Z.Z3 f1IY51-(C WAY
Company: Oo,nn Q,L- wAra ProprA�e,
City: 9o/L7- 51' 4-OG46, State:
Zip Code: .39986 Fax: VIA)
Phone No. .561 - Z62 - 010q
Address: 1-7o i rommF-neF Ave -
City: Vego Q,Q„ r,11 State: FL
Zip Code: 3a9(no Fax:
Phone No -7'7P.- s&a-Wo(o&
E-Mail: GegdgatoV 0 C104. COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License- . tiE��
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.
r0H D
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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
Address:
Zip:
BONDING COMPANY:
Address:
City:_
Zip:
Phone:
Applicable
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 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."
L� A 2 L I
a4idi / LAww�2�
t ature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Cont actor/License Holder
STATE OF FLORID
STATE OF FLORIDA� `
'011 PI
COUNTY OF e�GtCr,P _
COUNTY OF I" VW
The f9rgging instrumen was acknowledged before me
this ay of 200� by
The fgrgging instru t wa cknowledgpd before me
this day of 20 by
J_ANET f3. 1rnb'rE0
DP f A ry
Name of person making statement.
making
Name of person making st tement.
Personally Known OR Produced Identification
Personally Known Produced Identification
Type of Identification
Type of Identification
Produced :yr,fV&L6 1-I G,
Produced
enni L. Adkins
(Signature of Notary ' -
(Si n lure of Notary Public- Sta r TATE OF FLORIDA
w+'eve•., WILLIAMSURGEON
Commission No. "� '``� YCOMMI(0d�#GG136409
Commission No. . (oarr(�#0c061s10
c 1/11/2021
}'o EXPIRES:August 2B, 2021
xpi}es
Xa' ded Thm Nota Public Underxdtere
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19