HomeMy WebLinkAboutBuilding Permit AppAII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: o5.C.l.2920 Permit Number
J
re
Plonning ond Development Services
Building and Code Regulation Division
2300 Virginio Avenue, Fort Pierce FL 34982
Phone: {772\ 462-1553 Fax: 1772) 462-1578
Building Permit Application
Commercial Residential \/
PERMIT TYPE: Root inq
PROPOSED I MPROVEMENT LOCATION
Fu LAddress
Site Plan Name
Lot No q
\nrtiAfr PivtV 6ttot{,S BrockNo. aS
Project Name
DETAILED DESCRIPTION OF WORK:
Y{-- YoO+ (rnr tat\
5Y0.
,1
CONSTRUCTION IN FORMATION
Additional work to be performed under this permit - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction Sq. Ft. of First Floor:
Cost of Construction: $ts,0Co Utilities _ Sewer Septic Building Height:
_ Windows/Doors
Roof " l i,Pitch
OWNER/LESSEE:CONTRACTOR:
Name
Address
City:State: Lt
Zip Code:3$pX-f,Z- rr*
Phone No.
E-Mail
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
('
Name
Company
Address:
City:?ovr (\. \l^ut State: FL
Zip Code:Fax:
Phone mo-f-1}:3ffV Mro
E-Mail dl DM
state or county ricense CCL* \'1i\ iul0
lf value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
lf value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
Jr
property rax ro *, 3LIOZ - toOS- OO4B - O.@- -l
DESIGNER/ENGINEER: X Not Applicable
Name:
Address:
City:State:
Zip: _ Phone
MORTGAGE COMPANY:
Name:
City: State:
X ruot Applicable
PhoneZip:
Address:
FEE SIMPLE TITLE HOLDER:
Name:
f iarr'
Y Not Aoolicable
zip
Address:
Phone
BONDING COMPANY:
Name:
City:
\( Not Aoolicable
zip:
Address:
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 Countv makes no representation that is srantins a permit will authorize the oermit holder to build the subiect structure
which is in conflict with anv a'pplicable Home Owilers Asiociation rules, bvlaws or and covenants that mav restrict rir prohibit such
structure. Please consult with riour Home Owners Association and revi6w'your deed for any restrictions vihich may apply.
ln 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 OWIUER: YOUR FAILURE TO RECORD A NOTICE OF COMiTENCEMENT MAY RESULT Iil YOUR PAYING
TWICE FOR ITIPROYEIIENTS TO YOUR PROPERTY. A NOTICE OF COMMEIUCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SrTE BEFORE THE FTRST lIuSpECTlON. lF yOU INTEND rO OBTAIN FINANCING, COTUSULT
OR AI{ ATTORITIEY BEFORE RECORDITG YOUR IIIOTICE OF COiIMENCEiIENT."
Lessee/Contractor as Agent for Owner
STATE OF FTORIDA
couNTY oF t+. \ .rt(AQ-
Name of person making statement.
Personally Known _ OR Produced ldentification /
Commission No.
of
Ruth Eunice Cardero
was acknowledged before me
20 2\:, by
Signature
Type of ldentification
OF FLORIDA
Mr r ltavr S aur +t s
The forgoing i
this -l
day
Comn# GG930957
Elsff8. 11t12t2}23
STATE OF FLORIDAcouNrYoF st.'ur,tti{-
The forgoing instrument was acknowledged before me
this I day of Mo.,r . 2o 20 by
N\tv tu,,. lil rn,
Name of person making statement.
Personally Known
-
OR Produced ldentification ,'
Type of ldentification
Produced r ;! r', i
\ s
Commission No.
Ruth Eunice Cardero
NOTARY PUBLIC
Corffr# GG930957
EfiehBs 11t12t2023
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
SUPPLEM ENTAL CO NSTRUCTION LIEN LAW INFORMATION:
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