HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: • -S •ems--) O Permit Number:
Building Permit
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
PERMITTYPE: t, p C4,n al Z))e&,,�.
PROPOSED IMPROVEMENT LOCATION:
t
FEB 5 2020
on
Permitting Departmer
St. Lucie County, FL
Residential
Address: Z tF 9 S. Tr-d i a h 11 V ey DAP -; via Ff Piet-c tt-
Property Tax ID #: Z -3 S - 1 cf l - 00 0 Z - 000 - 0 Lot No. 33' 35'
Site Plan Name: b (--C (% P / Ch Block No. q0
Project Name:
DETAILED DESCRIPTION OF WORK: (. 1 __0 ('5 I
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: -;?-6 9
Cost of Construction: $ li g S 0. 00
_ Generator
Sq. Ft. of First Floor:
—Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name:
Address: �-Lq S_ yrd;a, r2iVer
Company:
City: P� Pl e r c f State: F/
Zip Code: 3 V % 6 Z Fax:
Phone No, S/ 6 77 9 tl7 23
Address:
City: State:_
Zip Code: Fax:
Phone No
E-Mail: S In10 ({ / F LO n Xc-, rr, cowL
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail
State or County License
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.PLE,MENTAL;CONSTR,UCTION
LIEN tAW INFQRMATIO'N , W
DESIGNER/ENGINEER: _
Name:t J Po-v n
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:-'' ru Yw �F
/ tma/e 5
Address:
City: e rf �� t.vc—
Zip: Phone -772
State a /
WV 799'2
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: _
Name:
Not Applicable
BONDING COMPANY:
Name:
_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 contlict 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 COMMENCEMENT."
a Content for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA 0 I� ))�
STATE OF FLORIDA
COUNTY OF �Jrh• C�!'1Gr�•
COUNTYOF
The forgoing instru nt was acknowledged before me
The forgoing instrument was acknowledged before me
this day of 20,-'>O by
this _ day of 20_ by
Name of perso making statements
Name of person making statement.
Personally Known OR Produced Identification 1/
Personally Known OR Produced Identification
Type of Identification
Type of Identification
II T
Produced 'N P W �l 0 YZi2 l) I� . �� f ,
Produced
(Signature of Not
Public- State of Flo ida)
(Signature of Notary Public- State of Florida )
Commission No.
: 4"r•""i. _ y� ARM
m mm 300817
Commission No. (Seal)
:Pt FJ(PIRES:Mmfi"8,2023
REVIEWS
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SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
ZONING
COUNTER
REVIEW
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REVIEW
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REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. T/77 IT