HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO RF ACCEPTED
Date:
Permit Number: ®ux" 0'7
apnI Is
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Planning and Development Services Q3�p�3t!
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 310t
Property Tax ID #: 23 Z o - $b I - e)OS-1 - n O6 - $ Lot No. S
Site Plan Name: 11ritAlo Block No.
Project Name: 5,en
DETAILED DESCRIPTION OF WORK:
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[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 y/,Z Pitch
Total Sq. Ft of Construction: 1-1/210 Sq. Ft. of First Floor: �44V
Cost of Construction:$ !(4006 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
i�T�lnem L a Ia
Address: AA-
Name: 1
Company: ,
City: IcY O&flce State: EG
Zip Code: Ir'%4e !C Fax:
Phone No.
Address: r
City: t- I Af1i/.P State: -,!SC
Zip Code: _ 3 y9 KS Fax:
Phone No 7 L- -o
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail Po k Pon cl .• P
State or County License?�9'?7 $
it vdme or wnsrrucnon is: cz=u or more, a nccunueu Notice or commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW IN
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLEHOLDER: _KNot Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: X Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Address:
City:
Zip: Phone:
Applicable
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."
V 'Y.LyvVV, V
1 g afure.ofOwne`r/Lessee/Contracto-as"Agent"forOwner
Sign ture fContractor/License Holder
S TE OF FLORIDA
STA O FLORI A
COUNTYOF !A . , uf_i f
COU OF . �i f
The for oing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
thisZ ay of k in (i ,_ 20ZO by
this` a(ay of Mv)»p sT_ 202b by
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r u
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification,z
Personally Known " OR Produced Identification
Type of Identification
Type of Identification
Produced S-SD3-b
Produced
,por kti Nntary Public State d
D Paschal
///I
MY
• My rommnsion GG
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19