HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
t - +
Permit Number:
Date:
r
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 I '
PERMIT TYPE: , . I -
PROPOSED IMPROVEMENT LOCATfON:
Address: '�()L4 TUIS _J N�� r�U
Property Tax ID #: �y�y �1���-�� L� Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
Mechanical Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 5�cy-) Oo
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name M tafuLq f -A
Name: .,X V 1f", L .
Address: - -TwAS - t1 FWS n\ .
City: �, �1 11✓ )r State: eL_
Zip Code: ,'�y� c�. Fax:
Phone No.
Company: A,_kiLAl
Address: \0\Q V� "'16(oaq
City: FA �► U State:
Zip Code:
Phone No ` �-1 ��` ►-its N- ?)S
E -Mail C,nXSo I A'Ci 1(k 14", (9nl LL) ti
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License (04
If value of construction is $2500 or more, a KECUKUtU Notice OT t.ommencement is reytureu.
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:_
Address
City:
Zip:
Phon
State
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:_
Address
City:_
Zip:
Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip:
Phone:
Not Applicable
tate:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby mace to otain a permit w uU L Ic a„u -
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
structure. with
with pypoiurHlome Owners Association Owners tiandrreviewyyour deed or any restrictions nts thait wh ch rict or may apply. such
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
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner Sig t4Ue of Contractor/License Holder
STATE OF FLORIDA I STATE OF FLORIDA
COUNTY OF _r . � _>< t Nj, COUNTY OF
The forgoing instrument was acknowledged before me
this tZ\ day of 1f.i�= 20,1L by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(SignaWre of Notary Public- rSt
Commission
REVIEWSI FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
The forgoing instrument was acknowledged before me
this t day of 20,,(i by
�= HR+LA-I
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
—mod
tai e of Notary Public- State
�'�
Notary Public State of FI
aMytargaret E Montep'I
GG 214
ride 1 C� Notary Public State of
�om ission No.�C t 1� I)IWargaret E Montep
9 ;a, My Commission GG 2
,� ; .
�p
��
My Comm Commission
Expires 08/05/2022
4a
Expires 08105/2022
a ^0'
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW