HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a ab Permit Number: ado -dG �a
of
Planning and Development Services Building Permit Applic:
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
FEB 2 4 2020
ST. Lucie County,
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE: I-P GA S
Property Tax ID#: 33Q/- o-- 00%-ppO
Site Plan Name�AaMEOAS E e u AA s E qe W
Project NameC !;a)Ad E t TA A,.a .N cocv .
Additional work to be perforyied__unfr thjs per " - check all that apply:
_Mechanical _Gas Tank eJ`f Gas Piping _Shutters
_ Electric _ Plumbing _ Sprinklers
_ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ %c •
Sq. Ft. of First Floor:
Lot No. `1 �5
Block No.
-Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Bulldin¢Heicht-
�m
;.OWNER/LESSEE,
Name E E T .ffx.,r.
-
i,CONTRAGTOR1,111, „ -. �
Name:
Name:
Company:
Address: iZ S E
Gty: V C State: At
Zip Code: ? / S; iCy Fax:
Phone No.27_;1 `IS" 03
Address q� 5W low
City_ VALJ4 CtTY State:
Zi Code:3Y990 Fax:
Phone No - C. ZL - 7
E-Mail:_ GP— 2fass
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail luxariL.
tOMAO Olin bA •
State or County License flQSS9
If value of construction is S2500 or mom_ a ncrnnncn ni...._.. _.
- - - -- -- '_......-...�...�. .. cyu.. eu.
value of HVAC is $7,500 or more, a RECORDED Notice of Commencement Is required.
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLEHOLDER: _ Nat Applicable
City:
Zip: Phone:
COMPANY: _ Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Address:
Zip:
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 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 COMMENCEMMM MUST BE RECORDED AND
POSTED
WITH YOUR LENDER OR AN ATTORN FIRS oes�m wON. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
�a et�
L.
otgnacu f owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORID
COUNTY OF_ �T,
The f r oing ins was a cn wledged before me
thisbDday Oi M� 20�yy
Name of person making Y ment
Personally Known X OR Produced Identification
Type of Identification
Produced
STATE OF FLORIDA
COUNTYOF \- UpAF
The f r oing inst nt was ackn wledged before me
thisdayof'� 20C_)t)by
Name of person makiinng statement.
Personally Known X OR Produced Identification
Type of Identification
Produced
(Signature of No pu fo- bJsl�FW-P - I®
Commission N ;State qt Florida -Notary Public
Co on a GG 190282 Commission
"s7 P` My Commission Expires f
REVIEWS I FRONT ZONING COUNTER I REVIEW ' I SUPERVISOR
R I RPLANS EVIEW I VRE EWON
REVIEW
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