HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,
Date: _��"d� jn1 b n�, Permit Number: R
44 ePd
Building Permit ApplicationQc°u^�e
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential \l�
PERMITTYPE: Spa �� f_a4-41,� -11u -e'
PROPOSEU I MPROVEM ENT LOCATION:
Address:
PropertyTax lD#: gd,a4 - SDI - OOgu- 000-4 Lot No. F6
Site Plan Name:
Project Name:
LED DESCRIPTION OF WORK:
a- It, Snalc -Fat. -' IN &.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
Block No.
Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
Electric _CPlumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction:lja c M31 Sq. Ft. of First Floor: 3i o4 g
Cost of Construction: $ 25815$0 Utilities: —Sewer `A Septic Building Height:
OWNER/LESSEES
CONTRACTOR:
Name =,nlh+--t No-rd Uov+
Name:-:YciAv\ A. c",c a --
Address: 5907•-
Company: lYYty� &t.tap'rs
City: ?-.ercP_ Stater_
Zip Code: .3`igg 1 Fax:
Phone No.
Address: Jill EW PSL, GlUct-
City: Pbrk 9`. Ls.o,-r. State: L
Zip Code: 3LIg53 Fax:
Phone No _711—
E-Mail: M��O -5,0 P7 Lto� • f.0�P7 L1oI�
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail T Wt
State or Coun y License GG
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. I
G4„y
SUPPLEMENTALCOUSTF'
CTION'LIEN,'LAWINFOR IVIATION
DESIGNER/ENGINEER:
Name: C1,eis Geees
_ Not Applicable
w6-k 4e-"
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: 5101 &,-,.a Pai.A.A.
Address:
City: ISark%+ pork
Zip: `--& 1 Phone 9
State: i
1-102&- 063
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
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 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 OFiCOMMENCEMENT."
X
9
Sign re of Owner/ Lessee/Contractor as Agent for Owner
signature of Contractor/4 Jense Hold
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF wk
The forgoing instrument was acknowledged before me
The for Ding instru ent was acknowledged before me
this _ day of 20_by
thisi dayof_20ZOby
Sohn Anthony 6rozq
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known -Y—\— OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public -State of Florida)
(Signature of Notary P c-State of F50WV1k00
Commission No. (Seal)
II11Qn c�
Commission No. V8_1���7
BRIANNA GRAHAI
py COMMISSION
IXPIRES: APR 02. 2
Bsntled through 1stState I
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev. 217719 1