HomeMy WebLinkAboutBuilding Permit Applicationv� I .ri e =
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �[� o�
Date: - %9 e�D�� Permit Number: oZ p /
Building Permit Appl FCEB 1 9 2020
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300Virginia Avenue, Fort Pierce FL34982 7WwAVv� St. Luce C ntyr FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT TYPE: AAA -row. TD EX/S7aG TDrvu r/vds�
Address: Z�il & AIA' APT. FT. �ii'/
Property Tax ID #: 7W-0/67^4770 - ' Lot No.
Site Plan Name: Ge4L LL'Oti/ TD/,>u/tOCIS,,9 Block No.
Project Name: L lcA" 1r12,UG AOQlf /Dic/
Additional work to be performed under this permit- check all that apply:
�Chanical _ Gas Tank _Gas Piping _Shutters
✓Electric +!Plumbing _Sprinklers
Total Sq. Ft of Construction: / 7O
jo!!�Wi ndows/Doors
_Generator _Roof Pitch
Sq. Ft. of First Floor:
i
Cost of Construction: $ (oS Dav, Utilities: ewer _ Septic Building Height: / d
OWNER%LESSEE:
CONTRA Ti0Rt
Name. L/S/1 APA445
Name: dkfg4.f Loy
Address:_Z9347.S N %`rG+1kJA- AIf� v�T�
Company:CAJI— icp��/LS
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Phonef�o, —__^ 'P
Addresls 3310 Sir%= oif+ �G,
City �� r !/GtL" n. / n,g5Atate:`
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Zip Code 3rlq'�/ 4'P 9x3 mFaz:.
Pho4No 772'.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail CNL o2�J33 �JVTi/ JU/%
State or County License
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. / Q [! 1 Y7�
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. T
S P - _M i. C►ONSTR
ON
I ,
DESIGNER/ENGINEER:
Name: MIk-9' h1AA/.4jW
_ Not Applicable
MORTGAGE COMPAN- : _ Not Applicable
Name: a
Address:
,,W
Address
City: Fi illAnAre"
Zip: Phone 66/o0-
State:
7ZV
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 Y_0UR.IENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
0
Signature of Ow er/ Lessee/Con actor as Agent for Owner
Signature of C tractor License Hol r
STATE OF FLORIDA �A
STATE OF FLORID -
COUNTY OFF' /
COUNTY OF G '
The f�jr� o�ing instrum nt as acknowledged before me
day
The forgoing instru ent was acknowledged before me
[
this / of 20�?
this day of 20 by
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
(Signature o otary Public- tate of Flor da)
(Signature of N _y ublic-'State of I
Commission No. AUOREYB.flWMREY
....... AUDREYB.H HREY
Commission No .'' '• ""•. ICI ��0p811
m? ; MYCOMMISSION#GO300817
1 March 6.2023
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REVIEWS
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PLANS
VEG
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MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19