HomeMy WebLinkAboutScan May 13, 2020 at 3.32 PM BUILDING PERMITAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ZU Permit Number: a0��,y3
- 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:WIMJOVJs lloof's ►.
PROPOSED IMPROVEMENT LOCATION: �
Address: OC &M S 1U A 6 61 1,�,�i
Property Tax ID #: Jq '�� UU��'��J Lot No._�
Site Plan Name: Block No.
Project Name: 6 alun
a 336 'Of
CONSTRUCTION INFORMATION: j
Additional work to be performed under this permit — check all that apply:
_Mechanical
Electric
Gas Tank
_ Plumbing
Gas Piping
_ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $.�D, N
_ Shutters
Generator
Sq. Ft. of First Floor: _
'Utilities: _ Sewer _ Septic
V Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name G A i A, d _ 2l1 1•LC_-=
Add s: 0 S.1 il.J�u%C� �JW
City-S)— _ Stater
Zip Code: 3�� Fax: ------ ----
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Phone No. � �/ 7_ 'f �j�f
E-Mail: _ 1CG11��t1�K [�L
Fill in fee sim Title Holder on nexKage ( if ifferent
from the Owner listed above)
Name:
Company: Ul�%
Address:1) _
City: _�I �— - - — -- - -- State: JW
------
Zip Code: _ _ - Fax: --
p .�s�5�'_-- - --
Phone No _ _L�0
L
E-Mail a 96 GV �W �
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 CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State.
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: — N t Applicable
BONDING COMPANY: of Applicable
Name:
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 TO 9BTAIN FINANC G, CONSULT
WIT UR LENDER OR AN ATTORNEY BEFORE RECORDIN UR NOTICE OF CO MENCEMENT."
i t �•
ture ner/ Les ontractor as Agent for Owner
Sign of Contractor/License Holder
STATE OF FLORID
COUNTY OF,
STATE OF FLORIDA
COUNTY OF _�%i 1�
The for oing instrument was acknowledged before me
this day of M64 202� by
The forgoing instrum r t was acknowledged before me
this _51 day of 20 ` Nv
M66V NPRI I 6A
kv rot i y
Name of person making statement.
Name of person making statement.
Personally Known--�- OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Produced
Type of Identification
ProducedQ-2)_`.co - 0 11
' _ DANIKER HJNT
11;NotaryPublic State of Florida
Commission r GG 017226 '
HUNT
�' ary Public - State of Flori,
(Signat re of a ublic ate o orI a
(Sig t re
o q�ub�j�c,�tgx�;��FlcUda2�2o
Commission N ����� (Seal)
Commissio
No. _F1 (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 - ------ ------ -- -- — —---