HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE IN,FrO MUST BE COMPLEi ed FOR APPLICATION TO BE ACCEPTED
Date: �Y i I-11 20 2. o Permit Number.. "
Building Permit
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMITTYPE: Ac),D1' 6V2r'
icatiorkPR 15 2020
Permitting Department
St. Lucie COu may,' FL
I PROPOSED IMPROVEMENT LOCATION: I
Address:
T
Property Tax ID#: 131)1-401—0106,1(DO—Y Lot No.
Site Plan Name:
Project Name:
Block No.
I DETAILED DESCRIPTION OF WORK: I I
v I
l Y) A-py-\c,#inner, �- A,n �e�-2u"o,�e Me kc..` ca vi Ck .Cln,"a-I-e..C_
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _
Gas Tank
_ Gas Piping _ Shutters
--Windows/ oors
_Electric _Plumbing
_Sprinklers _Generator
✓oaf Jr Pitch
Total Sq. Ft of Construction:
2`Z00
Sq. Ft. of First Floor:
Cost of Construction:$ ?QQQ
Utilities: _Sewer ✓eptic
Building Height: Imo_
OWNER/LESSEE:
CONTRACTOR:
Name Sear-) Bat I_tr'
Name:
Address: S OO `� C1 r-e -en D o l A k (h S 4
Company:
City: rOr4 ni ct State: Ff—,
Zip Code:: Mf Fax:
Phone No. \ - _I� Zg
- I -7
Address:
City: State:_
Zip Code: Fax:
Phone No
E-Mail: CinoeyWvloiSS Q)GMo,.( CnM
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.
SUPPLEMENTAL CONSTRUCTIO EN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
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.
no
the permit holder to build the subject structure
r and covenants that may restrict or prohibit such
aed 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 TOJA(.'BTAIN FINANCING, CONSULT
W U Vnlln ff C lnrn nn AWAA / ftilN nrr�nr nrr�nmun vn.le u�wrr rd urvrrur�l�• n
as Agent for Owner
Holder
STATE OF FLORIDA STATE OF FLORIDA 4
COUNTY OFF.LvG� COUNTY OF �\ • U6i,
The orgoing instrgnent was acknowledged before me The f going instru was acknowledge
'Rm d before me
this � day of Vt, 2080 by this x day of M by
<��A �
Kw I Nqr�
Name of person making statement. / Name of person making statement. /
Personally Known OR Produced Identification V Personally Known OR Produced Identification V
Type of
(Signature of Notary Public-S$,
Commission N�a��^� 1J
Notsfy Pubrm State of Florida
(Seal)
Type of
of Notary Public -
Commission No.
of Flodda
Mjcdmm"on GG 929457
Expima 1 V0312023
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.211119