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HomeMy WebLinkAboutbuilding Permit ApplicationIb SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: -+•�•.161y c11v1ffjS6n: —Not Applicable Name: Address: atv' State: Zip: Phone FEE SIMPLE TRLE HOLDER; _ Not Applicable Name: Address: qty: Zip: one: MORTGAGE COMPANY; Name: Not Applicable Address: City: ate: Zip: — Phone: • BONDING COMPANY: Not Applicable Name; Address: City: ZIP: — Phone: OWNER/ CONTRACTOR AFFIDVIT: Application Is hereby made to obtaln 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. S ole Courstryy makes no represenbtior► that is kl7anting ap�m it %11 authorize the permit holder to build the zub�t s uture whkh Is In confliR with ar� a�ppikabk Home Owners Assodatlon rules, bylaws or and eetienanes that may restrict or prohibit such Mucture. 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 aPPlkations are exempt from undergoing a full concurrency review. room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another nonresidential use 'Ir TITW FOR YOUR FALURIE TO RlE M A NOI OF COM AMCEM "MAY R>ESLLT N TOUR PAYNG PO6TEn ON DWROTHE JOB SITE llls�ORE THE FMST NSPFCi1D�L E NiE]ID i0 O ARIi F�� DEDCONAND WITH YOUR 11-811M OR AN ATTORNET eETORE RECDRDQYt: YOLIR NO OF • Signature of er/ Lessee/ as Agent for Owner4STAFLO WA r STATE OF FLORIDA COUNTY OF i'iiox tt fl COUNTY OF The forgoing instrument was acknowledged before me fieoing Instrument was acknowledged before me this �Nay of ' t 2020 by this of 2k0_0 by Kc r ri v nC 4tn l S Me C ta— Name of person making statement. I Name of person making statement. son Perally Known V/OR Produced Identification Personally Known OR Produced IdentHfgtbri Type of Identification Type of Identification Produced Produced I (Sl re of Notary Public- State of Florida) (Si ature of Notary Publio. State of Florida j commi:xi«-ta10 6611t5gp6 �OW uoww�t �IlfYiwloai00ttM Commission No. asJufrM,M?I • �geeljAuaf0011M01 EtOras Asss �0.>ntt REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW DATE REVIEW REVIEW RECEIVED DATE COMPLETED rev. All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce F! 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Permit Number: Building Permit Application Commercial Residential PERMITTYPE: PROPOSED '\6� � IMPROVEMENT LOCATION: �// "� �� AA —­ / f!� 1\I. �I 1A I�_ it JS i /bit II C+�JSoq Pr Property Tax ID #: `� l ~'�' ©C70� �pt�p Lot No. Site Plan Name: f Block No. Project Name: DETAILED DESCRIPTION OF WORK: Replr J oleo✓ d no 4 AZ%1 M a ✓ 11 CONSTRUCTION INFORMATION: a Additional work to be performed under this permit -check all that apply: _Mechanical — Gas Tank —Gas Piping _ Shutters Electric , Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: Cost of Construction: $ Sq. Ft. of First Floor: Flu' X%Nindows/SQ Roof Pitch Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name r'� s �� Name: j fkrar eec Address: p'� Q11'A.� Z Company: oim T� City: act, State: -� Address: 11/ #IiA Zip Coder Fax: City: P; z- State: -L - Phone No.R �� Z� Zip Code: Fax: E -Mail: 'Vetkol-iY (6P �61i •LQ^' -1 Phone No i btt:'565 P � J Fill in fee simple Title Holder on next page (if different E -Mail 0eJ4-%' see from the Owner listed above) tat or County License 00 If value of construction is 525DO or more, a RECORDED Notice of Commencement is requires. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.