HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a.` \3 \ 3
Planning and Development services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE:
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Address: NS I F_
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Permit Number:1�0�—O�J—}
RECEIVED
Building Permit Application FEB 1 39 7070
ST. Lucie County, Permitting
Commercial Residential
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Property Tax ID#: aWq-/30I-00/6--000^3 Lot No.
Site Plan Name:
Project Name:
Additional work to be performed under this permit — check all that apply:
Mechanical
Electric
_ Gas Tank
_ Plumbing
Gas Piping
_ Sprinklers
_ Shutters
_ Generator
Block No.
Windows/Doors
Roof Pitch
Total Sq. Ft of Construction: (q 7 OPP 6ek Mate- Sq. Ft. of First Floor:
Cost of Construction: $`000.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name T o6 floPi,;'5
Name:
Address: tJ SI 6o.era.lal AV—F •
Company:
City: I%dr'f %!iglu State: rL
Zip Code: 31141/S Fax:
Phone No. 77 oi.— Sa8- Sgoy
Address:
City: State:_
Zip Code: Fax:
Phone No
E-Mail: 3IL 1,00 9-Q be//SaL'-H'-he-f
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License
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.
FARRHEM MARGONS)TRUM
DESIGNER/ENGINEER:
Name:
ION N ,
Not Applicable
O
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
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 BuildingCodes 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 accessoryuses 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."
Sig ure of Owner/ L94see/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 63r. LSct
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this \3 day of 2d 0 by
this day of 20_ by
�q.cb� rcicl; �.s VAS
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 '(—�—�t—
Produced
(Signature of Notary li
gnature of Notary Public -State of Florida)
•• DEANNAMARIEGNENS
22023
Commission No. NIYCAM
2020
Commission No. (Seal)
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BondedTh,Nota1YPuhP.cUndervrtiieis
REVIEWS
FRONT
ZONING ,.
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. Z///19