HomeMy WebLinkAboutWoodhullApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTFn
Date:
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: Pr[UM Lr1 UYy-)
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID #:
Site Plan Name:
Project Name:,
Permit Number:
Building Permit Application
Commercial . Residential
1- .3 t I -0033-ODD -�
DETAILED DESCRIPTION OF WORK:
t -UN.') I KUL I ION INFORMATION:
O a
kdditional work to be performed under this permit –check all that apply:
—Mechanical — Gas Tank— Piping — p� g —Shutters
— Electric —Plumbing �/�} _ Sprinklers — Generator
otal Sq. Ft of Construction: � & p
Sq. Ft. of First Floor: _
ost of Construction: $
Utilities: _Sewer — Septic
UvvIVrK/LtJStt:
Name %�- '
kddress: ( S
'ity:C46State: f L
Zip Code: 3tii Fax:
'hone No.?,-
-Mail: Y
ill in fee simple Title Holder on next page ( if different
'om the Owner listed above)
CONTRACTOR:
Name:
Company:_
Address:
City: a WF-rCLi
Zip Code: 1`
Phone No -12Z --Z
E-Mall—Q&inayll
State or County Licens
a;uC or construction is $2500 or more, a RECORDED Notice of Commencement is required.
alue of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
Lot No.�
Block No.
_ Windows/Doors
Roof _ _ Pitch
Building Height:
(�GL.
State:
Fax
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENG NEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: IVYUS —0,f
_
ame:
Address.
Address:
City. State:_
City: State:
Zip; Phone �1_ `��^
_
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 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 IMPROVES TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE OB" TE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR.L JPJ ATTORNEY BEFORE RECORDING YOUR NOTJC F, C CEME T."
Signator f Owner esS a/Contractor as Agent for Owner Signature f Ca tra --r/license Helder
STATE OF FLO�,ID^A^,� 1 , STATE OF FLORIDA
COUNTY OF %r'1 (2� yfto,11a n
} COUNTY OF
The forgoing instrument was acknowledged before me The f rgaing instrument was acknowledg d before me
this � day of 202 by this1 day of M 20by
Name of person making statement. Name of person making statement.
gs
v
Personally Known OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
CA-
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(ign tura 0 Notary PubTic-'Statj of Florida i (Signature of N ry Public a
public State of Florida
Notary
Commission No No �kic5tate°fFl°nd�' /^ ,r e1 StaPVes
§5tapl�g ommission No. L �l"7 �;misaiorw GG 235102
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MY CnmrrtisaAan GG 235102 Expires 0710417022
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REVIEWS
FRONT
GG
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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