HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST B - 'IMPLETED FOR APPLICATION TO BE ACL« rED l�1/ a '1/�/ I/�cy/
Date: Permit Number: (X o a v`v Y
Nun°7 atfiul NW3ad
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Building Permit Application 01015ti
Planning and Development Services o30011
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 '
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
Address: Uo VL S/
Property Tax ID #: aaa& -600- 003/- 060-.S Lot No. odd
Site Plan Name: P.&-2�- le) • / Block No.
Project Name:
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Additional work to be performed under this permit- check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: go L Sq. Ft. of First Floor:
Cost of Construction: $ SO 0. aC3 Utilities: -Sewer _Septic Building Height:
Name Qn���.a� QQ1t0.frCM1Jln� Name: -' _ - -
Address: Q� rh/i���, irrZe�k�itJ• Company: T 00'L11 oAt i ` Z4C"
City: State: Address: /032D� p.9 ✓.t&h ft z 41 o2
Zip Code: 3I/9SZ� Fax: City: 1' a �dafGG-Q� State: AK
Phone No. 6/8- Zip Code: 'SV987 Fax:
E-Mail: Phone No 770? a0.3- 3y90
r
Fill in fee simple Title Holder on next page ( if different E-Mail,rjl/!/Jl/LtYDrM�d%'fi 0, C 4
from the Owner listed above) State or County License a
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.
SUP P+LEMENTALCONSTRUC?ION'LIO-b&INFORMATIQN
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DESIGNER/ENGINEER:
Name: Zr �' m
Not Applicable
. 4 .
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: Syyo 90yZegA42
&6
Address:
City:a .
Zip: 436b9 Phone B13
State: F4
3914- 61t�0g
City:
Zip: Phone:
Stater
FEE SIMPLE TITLE HOER: ,
Name: 11/
— Not Applicable
BONDING COMPAf�!9Y:
Name: /v
_Not Applicable
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 OF COMMINCEMENT."
I. A A ` 1. 117 -. J 1
as Agent fbr
OFFLO DA
fY OF _ P XDj L C `�
forgoing instrVment was acknowledged before me
day of rf!P '< CA* , 2020 by t
Name or person n
Personally Known
T"ype of Identificai
Pi6dduced
(Signa ure of t
Commi 'on No
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
statement.
OR Produced Identification
OF FLORIDA QJ Ltt&a—
rY OF __X7"
fdrging-instrur Qi _+acknowledge,8&fore me
day, of 20_ by
of person making statement.
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`' Notary P/ibfi4 tate of Florida
-
Commission
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Comm.E)Boodpd,•"a..
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FRONT
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SUPERVISOR
PLANS
VEGETATI
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CID
REVIEW
REVIEW
REVIEW
REVIEW
OR Produced Identification.
SHERRI KELLEY Seal)
C"`MM ssfen# FF 9992J
Expires October4, 2020
REVIEW I REVIEW