HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: n
_ � - �C)�O Permit Number � ( �
� DePBnment
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Building Permit Application
Planning and Development services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE: . P. GAS
Address:
Property Tax ID #:91.24-903 -Q04 J - mo - O
Lot No.
Site Plan Name: al JEwlt_C R G RA 2
Project Name: l,A W (� er( C.E `�1 (.tc-A A ,Q Block No.
I .wiv5 i Kuc. Aviv; INI-ORMATION:
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Additional work to be pertom}Cld under this perm check all that apply:
Mechanical I Gas Tank Gas Piping _Shutters —Windows/Doors
_ Electric _ Plumbing —Sprinklers _ Generator —Roof Pitch
Total Sq. Ft of Construction:
Cost of construction:
Sq. Ft. of First Floor:
Utilities: _Sewer Septic Ruildina Noiohr-
aQWNERLESSEEm
,uCi7NTRACTOR
Name ZE
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Name: _44
wM ;rF;s
Address: /6.2(0 S reE
Company: i 8, rr%J
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City: hit.l K [`.T1/ State: -
Zip Code: ,3f f 9,70 Fax:
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Phone N��o��
Address• f, j
W1r
City: V{ erml
Zip Code: �99'O Fax:
Phon1�
E-MaII Il/A; ,V'Q k / ZoA
State: F
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E-Mail:_/ GEBA► Q. a t L • IOWA,
Fill In fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License
If value of construction is S2500 ar mnro_ n nprnonrn k,,, . _..•__—_
f value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is reqlb laquirea.
uired.
I '..
Address:
City: State:
ZIP: Phone
FEE SIMPLE TITLE HOLDER: — Not Applicable
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not
Address:
Zip: Phone:
OWNER/ CONTRACTOR AFFIOVIT: 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 Counttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with anyapplicabie 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 IIISPECITON. IT YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDERAR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF it n mmurcwc n
hEa� /�
argnat f Owne / Lessee/Contractor as Agent for Owner
STATE OF
COUNTYOFORIDAU 14�AF
The fglgaing instr ment wa�a knowledged before me
thi day of 20aDby
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
�7
(Signature of Nota a
STATE COUNTYOFORIDAST, (_kl '\e
The foCgoing instrume t s acl owledged before me
this day of J�203Dby
Name of person making statement.
Personally Known _4 OR Produced identification
Type of Identification
Produced
(Signature of Notary Publ
nn
REDDIN
...... State ^�state ofla�,alile-Notary
Comm lssion
My Commission
e ruar
REVIEWS FR
COUNTER REVIEW
public Commission No. / -_Stet8,p1_�toride-Notar
0 GG 190282 r •= Co II�Ff
Ex ires°�p„ ��% My Commission
022 t` February
PLANS VEGETATION SEA TURTLE
REVIEW REVIEW REVIEW
y Publ c
ion N GG 190282
Expires
28, 2022
MANGROVE
DATE
REVIEW
REVIEW
RECEIVED
DATE
COMPLETED
ev. 211119