HomeMy WebLinkAbout2020-05-06 15-34All APPLICgBLEINF, MUST
Date: _ BE COMPLETED FOR APPLICATION TO BE ACCEPTED
J -
Planning and Deve-
Planning Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT
TYPE:
rene
PROPOSED IMPROVEMENT LOCATION:
Address: 2Y T
Permit Number:
Building Permit Application
Commercial Residential "./—
Property
/
Property Tax ID #: Cyt q - �,3 0 r �1 �7 - p DO }- Lot No. _
Site Plan Name: --)1� Block No. 3 _
Project Name: VM64d-C 5
DETAILED DESCRIPTION OF WORK: I
►IsTu I i �� v GOd � c� ��w✓l leffi u -r e �J 6oyie c/L'?y
oLE�ffl- _--per(-Y]cP- ��l �rn;li�aoo 1- 63&'3
CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit -check all that apply:
Mechanical
Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ ?960-
OWNER/LESSEE:
_ Gas Piping
_ Sprinklers
_ Shutters
Generator
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic
Name r� nG r-zl U 11( ct -C 5
Address: 33s Cc%d
City: PSL- State:L
Zip Code: �'� �c`f 7 Fax:
Phone No.
E -Mail: w �-
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
_ Windows/Doors
_ Roof Pitch
Building Height:
Name: 9Vi+;� doy 1 fit u- h,t CI -4k .
Company: L It 1-7 ct
Address: Co 6-V
City: f -s L --
State: L,
Zip Code: _3`/�/C�3 Fax: r1 /ct
Phone No 7 % ' 3'10 - 7 q 7
E -Mail (%4Uv✓�a,Y7 �i'iC� i vel /� Cwi
State or County Licensee 3 Cj
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.
SUPp(EMENTALCONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name: _ Not Applicable MORTGAGE COMPANY: + Not Applicable
Address------------ Name:
City: Address:
Zip: State: City: State:
Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: —
Address. Name:
City: Address:
Zip: Phone: 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 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 13E RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
,YMH YOUR LENDER OR AN ATTORNEY BEFORE RECORDINGVOUR NOTICE OF COMMENCEMENT."
Signature of Owner/
STATE OF FLORIDA �L
COUNTY OF ('
as Agent for Owner /I Signature of CoXractor/License Holder
The forgoing instrument as acknowledged before me
this day of nn ? by
� Prz4t cl c -yl- CA 01)&-t\
Name of person making statement. /
Personally Known OR Produced Identification V
Type of Identifica,tieri n
Produced 1 1,-
(Si�=v kq� 9 ��� -
gnature of Notary
u/bli -(S/tate of Florida j
Commission Nd.�C7 F-(°
NANCY J.SHEA
Notary Public -State of Florida
my mm. Expires Oct 19,
REVIEWS FRONT dNi'NG eM,d tSUPERVIIW
COUNTER
TATE
DATE
COMPLETED
STATE OF FLO
COUNTY OF
The for ing instrument was acknowledged before me
this day of 20-1-- by
Y r cT, � '�� �2 Yl
Name of person making statement. 6
/
Personally Known OR Produced Identification ✓
Type of Identifica ' n
Produced C— I —/,
—1 XetL�=Z� �)- <�k `7 "'
(Signature of Notary ublic- State of Florida )
No.CCCNANCYJ.
SH
EA Sia EA
i MY n mission k GG 144910
VEGETATION LE " 'e�i(�E
REVIEW RF' t �'ti`ue„ �hjV Wr.,,?C