HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �/V 3014 z6W Permit Number:
. - P ECErvED
Building Permit Applicata n
Planning and Development Services MAY ® 6 L020
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie C u y, Permitting
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resi en Ia
PERMITTYPE:
P 4 O f�D t PR01/ENT Lffl00 -'
Address: Co b y\ e
Property Tax ID#: 3po, C� ®00a Lot No.
Site Plan Name: �„�, e ey! . ZWWAI Block No.
Project Name::
Q T ) d QECR TION C1 'V1/DR
7-
,5 .ou
,5ou-7 se'
STRUCTl�N ( FOR ATION:
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: Ab 1A Sq. Ft. of First Floor: /l/le
Cost of Construction:$ 260,46 Utilities: _Sewer Septic Building Height:
O ER LE ® CONT AC
Name �J� ESa-cA R+G� Name: J;fpyzrS /d
Address: 6 7.0 2,CAtZ1'5D1J 1&u Company: ,SSG
City: Stater Address: 4
�ZoG��i��:�,san�
Zip Code: -3 3- Fax: ,y 1A City: 1-7- State:
Phone No. 7`7 Z 6 3 3`Z.j`'7s Zip Code: 3 f-S � Fax:
E-Mail: .S,��f -' , e No
Fill in fee simple Title Holder on next page(if different E-Mail 'd xOA-."
from the Owner listed above) State or County License c`L
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.
NSal 'P'LEMECONST UCTION �i N LA 1 • 7[flN
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: 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 thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws orand 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."
Signatu V
of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF_,&-r. �-o��� COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this F day of VN\ ,26-4.ir3 by this day of 20_ by
�.w.�s VStd��e
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of.ldentification Type of Identification
Produced �—X- o L Produced
(Signature of Notary ..
o-;btk" MARIE GlVEN
l S (Signature of Notary Public-State of Florida)
[l `�Y..... Iff
=2°' M9Y C01AF�lISSION#GG 022023
Commission No. -a:+ Plygf)cember9s,202UCommission No. (Seal)
%" \o Banded Thu Notary Public Underwriter '
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19