HomeMy WebLinkAboutBuilding Permit Applicationz
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �31� Permit Number:
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:
ENT LOCATION:
Address:
ERECEIVEDBuilding Permit Applicatio20ermitting
Commercial Residential
C
Property Tax ID#: N1`%- sdl- of 0q-600-2- Lot No.
Site Plan Name: Leo Block No.
Project Name: i-et ce
DETAILED DESCRIPTIONn
OF WORK:
1,,s4-e,v �q' tt,.kL r too-t, F-ehc-e. Z wa -9c. 5 4loJ iiE(U+-c.�F�'
CONSTRUCTION INFORMATION:
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: $ 2!21,2 00
Sq. Ft. of First Floor:
—Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name R44ic Z5
Name: r4,5
a cP a
Address: 14 i�qC) l�
Company: t�c�
fn/��<a�
�,�[
City: o at- s v (' State: (l7
6 & 5G
Zip Code: �ax:
Phone No. �ZZ- �O(S - �7(07
Address: lido SJ
C.ba +
-&Jc-
City: SL
Zip Code: .3 Yi 9'3 Fax:
Phone No , G%7fi - 23S$
State: PL
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail d�i'fvta . V-
yer k cd • [dri
State or County License (?S C- d'f
S-0
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 CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address: ATA
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address: A
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 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
0 V
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIgA[ STATE OF FLORIDA
COUNTY OF u� / LV//f �J COUNTY OF 5�
The forgoing instru ent was acknowledged before me
this day of n� 20�Oby
Name of person making statement.
Personally Known Vl� OR Produced Identification
Type of Identification
(Signature of Notary PuBIi<
Commission No.
REVIEWS FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
M
The forgoing instrument was acknowledged before me
this _:�. L day of rL 20 20by
Name of person making statement.
Personally Known 1/1*�_ OR Produced Identification
Type of Identification
State of
Commission No.
PLANS I VEGETATION I SEA
REVIEW REVIEW I RE
I KATI