HomeMy WebLinkAboutBuilding permit applicationAll 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 FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
Building Permit Application
Commercial Residential
PERMIT TYPE: 6'r'-5 f
PROPOSED IMPROVEMENT LOCATION:
Address: �y!✓ li�'`i�✓e5�I�C�C�-� �ic,�� ��M. ry_
Property Tax ID #: Q — a D D0 W
Site Plan Narne: hOM { 4L 5
Project Name:
DETAILED DESCRIPTION OF WORK:
ra(h .2-C'.�S �- q
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
Mechanical GasTank Gas Piping _Shutters
Electric — Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: 57,
Generator
Sq. Ft. of First Floor:
Lot -Pd Block No.
No.
":'L'Vc f
Windows/Doors
Roof Pitch
Utilities: _Sewer `Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 9le—r\ R hpmP5 on
Name: Blake Cowdell
Address:/!/' JOV 5wee_46q '
Company: Energized Gas
City: 'PC, [&% �14 State:
Zip Code: IA4 Fax:
Phone No.
Address: 1786 SW Biltmore St
City: Port ST Lucie State: FL
Zip Code: 34984 Fax:
Phone No 7727778133
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail energizedgenerators@gmail.com
State or County LicenseLG34747
ie vd[UU ui cunsuucilun Is 4,LSUU or more, a KLLUKDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
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 OF COMMENCEMENT."
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF-
STATE OF FLOLJDA-
COUNTY OF
The oing instrurqent wa acknowled before me
this ay of {E 20�y
The rgoing instr entj(�+'as acknowlecp, before me
this+ lay of y(� 4 2t3'(m'�t1))y
l � Lj�=, i
_-1w �k a. IJ
Name of person making statement.
_ _
Name of person making statement.
<_
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(5ignatu Y PI (4f#1 I if �4B
(S ta* t at V# RIN9l88i �t s $ bfid )
EXPIRES: 22
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EXPIRES'
Co r` 11 ,p 1V cldonded Tbru Notary Pu:sl:o Untic nvrlte Y
Commissi .••oFr.�°• 88ndedSArli-NotaryPubllhUttd:
REVIEWS
FRONT
ZONING
SUPERVISORPLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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