HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
JJ
•
Building Permit Application
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 Residential
PERMIT TYPE:
PROPOSEDIMPROVEMENTLOCATION:
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Property Tax ID#: L/IO ''r�-o3— Q IdS Q0 0— tl _ Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
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r"1Ei'NO✓t f/ ����lnrl Sh,N�/eJ' �.' ✓yL�V✓ .`''—/'! %� ',
56-7, 3� 2
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120 r,-.
CONSTRUCTION INFORMATION: /j ��21, YJ I
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:
Cost of Construction: $ I /r Utz C)
Sq. Ft. of First Floor: _
Utilities: _Sewer _Septic
Windows/Doors
Roof Pitch
Building Height: /
OWNER/LESSEE:
CONTRACTOR:
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Name In /1 /0J f7
Name: an0 L4JI rk
Address: 52 3 0 Tr -211"-/{,2 W i Y
Company: Ghg-dqy 146e'ym,4
City: /4• %se r« State: FL
Zip Code: Fax:
PhoneNo.
Address: 7?q %,IA CEgdf fliL Y fV ji,.'Ie y
City: F17/m C ecli/ State: FL-
Zip Code: �2-/17 Fax:
LPhone
Phone No M - 3W ''' G
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail )�r h'� f7i�� 4, % ( "P7
State or County License G� 133a l"U
If value of construction is 52500 or more, a RtCumitu Nonce or Lommencemenr is requmreu.
if value of HVAC Is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ 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.
St. LucieCounty 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 BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENnFR OR AN ATTORNFY RFFORF RFCI1Rn1NC.. YOIIR NOTICE OF COMMENCEMENT."
Rev. 2/ // ly
Signature of Owner) Lessee ontrartor�as Agent for Owner
Signature offont LLiicense Holder
STATE OF FLOF�IQA
STATE OF FLORIDA
COUNTY OF W5:�o
COUNTY OF 4-IArA8jP
The for oing instrum nt was acknowled before me
this. 2 by
The for oing instrument was acknowledge efore me
this�daay\of I 2 by
1da(y�of III 1
so—
Name of person making statement.
Name of person making statement. *
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Personally Known OR Produced Identi
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Personally Known OR Produced Identific
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Type of Id,e;ni�ificat�ion
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Type of Identification
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(' n rem otary ublic- State f Florida)
ignature of Public- State of Florida)
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Commission N�G I (Seal)
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Commission N � (Seal)
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REVIEWS
FRONT
ZONING
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/ // ly