HomeMy WebLinkAboutBuilding Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2U Permit Number:
J
Building Permit Application
Planning and Development Services
Building and Code Regulotion Division
2300 Virginio Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential_
PERMIT TYPE: J
wlmhvt��I'Nots."+
PROPOSED IMPROVEMENT LOCATION:
Address: OC � ,tA & JVn N V
Property Tax ID #: I`tQ 'tor" UUok/'COO Lot No.
Site Plan Name: Block No.
Project Name: n
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
_Mechanical
Electric
Gas Tank
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ , -w- - - -v—)
Gas Piping
Sprinklers
Shutters
_ Generator
Sq. Ft. of First Floor: _
I/ Windows/Doors
Roof
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: I CONTRACTOR:
Name A it71MA14 _ 14- —
Add s:
Cit y��- Stater
Zip Code: Fax:.----
Phone
ax:._Phone No. 12 _ -c:Q%_? _/
E - Mail: ;r- 014AadlAAtIu(Lif I lk�6G;l
Fill in fee sim* Title Holder on next`page ( if different
from the Owner listed above)
Name: C
Company:
I MR
Pitch
Address: Q U 1,V • Yy c9 Y 711 r(r
City:!' State: -J1.1
Zip Code: Fax:_" �'� _
Phone No - to -4 Zc�O 6M
E -Mail I�5 C- zoo
State or County License 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:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: ! Not An
Name:
City: _ State:
Zip: Phone:
BONDING COMPANY: of 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. 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 TOBTAIN FINANCJ�G, CONSULT
WITUA- OUR LENDER OR AN ATTORNEY BEFORE RECORDINC.XDUR NOTICE OF COrMENCEMENT." I
er/ Lesslob/tontractor as Agent for Owner I Sign.,ute.of Contractor/license Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF X01 COUNTY OFol I UM
__�%j
The for oing instrument was acknowledged before me
this day of 202� by
M6016V Weal 116A
Name of person making statement.
Personally Known __y___ OR Produced Identification
Type of Identification
Produced_
�� '• DANIKER HUNT
' I Notary Public • State of Florida
Commission + GG 017226
(Signat re of a ublic- ate o orI a
Commission 41 ��� (Seal)
The forgoing Instrum t was acknowledged before me
this _� day of 209 _('�by
�OA
Name of person making statement.
Personally Known OR Produced Identification
Type of Iden ification
Produced_RUE-RUE-SQ- 2DS U
ioilyiD RHUNT
ary Public - State of FloriCa
is GG 1724
(Sign btre o e q��ub�j�coWAttx@ifAIAr4da2b2-0
CommissioIIg0 IAL'&II(Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGEFATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE -- ---- ---- ----
_RECEIVED
DATE
COMPLETED _
Rev. 2/7/19