HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1a�1 a d Permit Number: a d0 1
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: W
Address:
t1c I
RECEIVED
Building Permit Applic ion�AN 2 3 2020
ST. Lucie County, Permitting
Commercial Residential
= 7/Ii-- a 167—
Property Tax IDN: Lot No.
Additional work to be performed under this permit -check all that apply:
_Mechanical
Electric
Gas Tank
_.Plumbing
Total Sq. Ft of Construction:
Gas Piping
Sprinklers
_ Shutters
_ Generator
Sq. Ft. of First Floor:_
Windows/Doors
Roof, Pitch'
Cost of Construction: $ iY� \ OQ 00 tilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTR OTLOR:
Name nr ro Co{�i
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Name:-A4j jL0 t✓vr A2 rt44 4-L
Address: N
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Company: (DA VPQ 6, ii-A -3H,4cL 1. c, j.,-
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dl m fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License G 4P C
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,.,.,;
ET11 LEON T1.0
DESIGNER/ENGINEER:
Name:
10
Not Applicable
MORTGAGE COMPANY: , _ Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
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 commericpd 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 fespects, 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 UNDER, OR AN ATTORNEY BEFORE RECORDING YOUR NQTICE,OF,COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signkfure of Contractor/License Holder
STATE OF FLORIDAII'�
COUNTY S4- (mil (2t-c
STATE OF FLORIDA 1 '
OF
COUNTY OF L t tC� P
The for oing instrument was acknowledged before me
The fQ,rgoing instrument was acknowledged before me
`1
this day of TGQ') , 20 20 by
this I day of -y Wr , 202_0 by
Is4 wnrsl a_ I
_2-�eyeclu Marsha/
Name of persoi making statement.
Name of perso aking/statement.
Personally Known �� OR Produced Identification
Personally Known 1 •. OR Produced Identification
Type of Identification
Type of Id6tif cation -
Produced
Produced
(Signature o otary-Public- State of Florida) •
(Signature ofYotary Public- State of Florida )_
S D. MARSHAL
Commission NCommissionNo: o. ?f BEVE
gMIMARSHALL
0, `sy� Notary Public - State of Florida
'
Public -State of Florida
S•. .•:Notary
' CommissionN GG 057931
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