HomeMy WebLinkAboutBuilding Permit ApplicationII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �0 da)' J
Date: 3— z- QaAa
Permit Number:
Planning and Development services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: �S
Address: LLB
Property Tax ID q: 23y
Site Plan Name: M HA
Project Name: _c_ }Q /J
Building Permit
n
MAR 0 2 2020
Sr. Lucie County, Perm
Commercial Residential V
Lot No. !Z
III k No.
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SA oorJ V o /la2 Nf.0 /N $ fit oc�7�o4. �Xrnf�J �wS7iNG
a . S % NeweN . Co NAl2 Pi R.
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CONSTRUCTION INft7RMA710N
Additional work to be perforr d under this per%it—check all that apply:
—Mechanical V_ Gas Tank V Gas Piping Shutters
—�. _
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
wSq. Ft. of First Floor: _
Cost of Construction: $ V +00 Utilities: _ Sewer _ Septic
—Windows/Doors
-Roof Pitch
Buildine Heieht:
Name O u
'CONTRAC -OR'
Name: Ar4 Pl
Address:131122 UNIatl RD
Company: P/ (bu �nle
City: as t2 State:_.
Zip Code: �3ti98% Fax:
Phone No.
Address: a%% SIJ ,a Lot/
r�/�}{
City: Ct (1/ State:
Zip Code: 3 0 Fax:
No • tiZ4 ^
E-Mail liLV 1I1 Ct)/tlD gr�1A • Ct
State or County License rj!
E-Mail:J—A LL 214 C46'l /40LCQKPhone
Fill in fee simple TitILYHolder on next page (if different
from the Owner listed above)
If value of construction is 52snn nr mnrn DCrnonrn .,_.,__
- - -- v„cna ,a , equlrea.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement Is required.
Address:
City- State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Address -
City: State:
Zip: Phone:
BONDING
Address:
City:
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 Counttyy makes no representation that is granting a permit will authorize the ppermit holder to build the subject structure
which is in co ilict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Nome 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 FOIST INSPECTION. IF YOU wrEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTWF nF rnmurm,... n
_Not Applicable
Signacu f Owne / Lessee/Contractor as Agent for Owner
STATE OF FLORID
COUNTY OF
The �g oing ins t as ackn wied before me
this day of � 2tby
Inns C`1,�1 5� . )
Name of person making statement.
Personally Known _X_ OR Produced Identification
Type of Identification
Produced
Commission N �:';Stata Rf,,'FF rida•Not
•= Cort115sf4 ion M GG
'.�oA oAl" My Commission
STATE OF FLORIDA�
COUNTY OF_ �
The forgoing inst m t was a kn wledged before me
thisoday of: � 26C)Cby
Name of person making statement.
Personally Known OR Produced Identification
Type of identification
Produced
(Signature of
ion N GG 1
mission E
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