HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
RR111111111 III
COUNTY
F L O R I a A
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE:
PROPOSED IMPROVEMENTLOCATION:: �� [�
Arlrocc• ,( 569 sI 1 Uc�p r)d.l� ;brz— .
Property Tax ID #: -�40,2- " (POI - o1�,0 r O(6 _2 Lot No.
Site Plan Name: Block No.
Project Name: ELEO QIC6> - TO& 5At L
DETAILED DESCRIPTION OF WORK:
1ras lox) a t <<frl�� 24O 4#4p kefca M666
_S0 6 �pqE{ wL � out 1-e.� o� s � (11, L4fiS CONSTRUCTION INFORMATION:
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: Sq. Ft. of First Floor:
Cost of Construction: $ V+CUtilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name CUK,!`-;6s 60i _
Name: e� ^ U[L
Address: SOW0 st(VI C PACt 1289--
Company; `1i2tiV �21 U—ti
Address: SC d 4d2'
City: rmi 1Ai State:FL.
Zip Code: Fax:
City: Fort Si- WLI G Stater:1F(1
Phone No. '4�+t- ` y -104D
Zip Code: 3y Fax:
Phone No 417- 4 + 40
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mail 1pt�1thl�l �E iGL�C 6 • CA�•(r
from the Owner listed above)
State or County License EC 13 qoa33
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,
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: — Not Applicable
Name:_
Address:,
City: _
Zip:
State:
Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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 concurrenty review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and acc on -residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY ULT IN YOUR PAYING
TWICE FOR IMPROYEME YOUR PROPERTY. A NOTICE C M CEMENT MU T BE RECORDED AND
POSTED ON T SITE EIEFO THE FIRST INSPECTION F YOU D TO AIN FINANtING, CONSULT
WITH Y ER OR AN ATTOR EY RECORDIN YOUR N I NC ENT."
Signatureof wner/ Lessee/C ra as Agent for Owner
e Holder
Signatur of Contrr��
STATE O FLORlDA
COUN OF
STAT OF FLOR
COUNTY
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The forgoL�i,,gpg instrum nt as acknowledged before me
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The for ggi�g instrum t was cknowledged before me
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this 2�'�lay of �r 20� by
this of 20gWby
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Name of person ma ng statement.
Name of pon making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Eden "ficat1on
Type of Identification
Produced L 3\
Produced
(Sign ure of Notary P ibli ate ofFloridaI
(Sigrpfure of Notary Public- State of Flo
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(Seal)
Commission No. (�
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Commission No.K99-+
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Notary Public
Commiss�or
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
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MANGROVE
COUNTER
REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Kev. 2///15
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