HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOIL APPLICATION TO BE ACaPTED
Date: _ T< .z Permit [Number:
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 APPLICATION- FOR:
RIMMED
Building Permit Application APR 2
perrnittfng Depai'tmeni
St. Lucre County
Commercial Residential,
c
11 _Mechanical —Gas Tank Gas Piping Shutters
Electric _ Plumbing — Sprinklers ^Generator
Total Sq. Ft of Construction: ' t1/ 4 _
Cost of Construction: $ Q €
Sq. Ft. of First 'Floor: —
Utilities: _Sewer —Septic
Address f 0 -ad • Qi - .'Ift ,P U
City: `, 1''i , x C,e- .� . State;
Zip Code: 1
14-T ` r ;FaWt's___
Phone No. Q�--� 3 ,e
E -Mail: ' /A
Fill In fee simple Title Holder on next page (if different
from the Owner listed ab6ve)
Windows/Doors
— hoof ", Pitch
k
IName:_iiien*a,f'-Uc "
Building Height:,
Company: CoA.ff,r-%
Address:.. J.2 1r
Citi:
Zip Code: G f c Fax: ?72- V6 /- 6�Y.r
E -Mail %df�?� �• �joG►. .s
State or County Licensed"CGt 11S��,�'G8
If value of conaruction Is 2500 or more, a REtOWED N06ce of Commencement is required.
Address:
0 c, cwAe,v--e
.
7 or T F x' G Y c- .
Legal Description: qms C I) 0 � U�� , �
OF E y2_ OF L' tWyy D � 1►� V�+ ,
OF S0' kt�tin rn1 1 b� FT
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Property Taxi®-#: ISM-
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Site Plan Name:(
.� -J2? 'Block`INo.
Project -Name: AriDoks
Setbacks Front,
Back:
Right Side:`
Left Side: —
11 _Mechanical —Gas Tank Gas Piping Shutters
Electric _ Plumbing — Sprinklers ^Generator
Total Sq. Ft of Construction: ' t1/ 4 _
Cost of Construction: $ Q €
Sq. Ft. of First 'Floor: —
Utilities: _Sewer —Septic
Address f 0 -ad • Qi - .'Ift ,P U
City: `, 1''i , x C,e- .� . State;
Zip Code: 1
14-T ` r ;FaWt's___
Phone No. Q�--� 3 ,e
E -Mail: ' /A
Fill In fee simple Title Holder on next page (if different
from the Owner listed ab6ve)
Windows/Doors
— hoof ", Pitch
k
IName:_iiien*a,f'-Uc "
Building Height:,
Company: CoA.ff,r-%
Address:.. J.2 1r
Citi:
Zip Code: G f c Fax: ?72- V6 /- 6�Y.r
E -Mail %df�?� �• �joG►. .s
State or County Licensed"CGt 11S��,�'G8
If value of conaruction Is 2500 or more, a REtOWED N06ce of Commencement is required.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY:
Name: Name: Not Applicable
Address: Address.-
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: / Not 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 theermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or an9covenants 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing-work or recording your Notice of Commencement.
Signature of Uwner/Lessee/Contractor as Agent for Owner §rgnature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF Luu
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thisi day of ktAi2e4 202,E by this/fes day of kM 9C* 202-0 by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Idtification Type of Idqntification
Produced='Opr. DfA%116-4 Ll bp� Produced Vtoyri-f* yu I D6'Y--
nature of Notary Pt6liC-Statg4f-146rida A of Nota- OwWic,'Stat6�rljda
I atu e Notary a5
00 01 00f
LW state
Commission No. 9�A� MMISS10 No.ld lb
5�a I GG -10 n Lb
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Of;
X01
REVIEWS FRONT ERVISOR PLANS VEGETATION MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW
I . . .
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17