HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFOMUSTBE COMPLe7e0 FOR APPLICATION TO BE ACCEPTED , Q V Date: ,• i5 • �li�� Permit Number;cT� )07 n
D
NIMIR
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 TYPE: 13 a i, lte
Building Permit Appl
Commercial
c
cation JAN 8 2020
Permitting Department
St. Lucie County, FL
Residential
Address: 01,�'14 getS�_- Lane 'PSC j1L JYgY4
PropertyTaxlD#: D,)S 2� 1 09 _71 0dD 4 Lot No.
Site Plan Name: Er ranl rl-eZ (Zt•S rcV a „c -( Block No.
Project Name:
Additional work to be performed under this permit —check all that apply:
Mechanical _Gas Tank _Gas Piping _Shutters ✓ Windows/Doors
V,Electric vPlumbing _Sprinklers _Generator , "_,/-Rdof- Pitch
Total Sq. Ft of Construction: S') DS— Sq. Ft. of First Floor: 1'7 'V /
Cost of Construction: $ Oa Utilities: —Sewer Septic Building Height:
City: t State:17L
Zip Code: &;M I-? Fax:
Phone No. a 4
E-Mail: M4
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: W,,LL.1 1�r• d- �'l<.,c.eS �
Company: 1) f fra.,., czstJ
Address: !R2 yz) LrM r 56»,r P?xt 7Ya•.'L-
City: f ? he-ft -State: r— L
Zip Cod e:3444S7 Fax: 772 t/44�7E73
PhoneNo-72i 101 2%17
E-Mail A t 4-�r" eoMSAyK /0- a- L- • eO'kn
State or County License IZ $ 21100 3LZ 1
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.
(�'3(:�'6\
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY:•
Name:
't/Not Applicable
Address: 61- &Iu&-rt 0-,r-e
Address:
City: Fr State: '
Zip: 3llcig Phone 4Go 77s/
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: r/Not Applicable
Name:
BONDING COMPANY:
Name:
of Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDAVIT: 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 OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCE n
Signature of Owner Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA `
STATE OF FLORIDA
COUNTY OF
COUNTY OF _LC%
The forgoing instru nt was acknowledged before me
The for oing instr t was acknowledged before me
this � day of 20��y
this day of 2Q.22 by
ry)', e-�r-ar>r ls� o
d�!•,n r i��o
Name of person making statement.
Name of person making statement.
Personally Known` OR Produced Identification
Personally Known '_'� OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Not Pub lic-Sta ''S
(Signature of
b' - �-�
AUDREY B. HUMPHREY
`
,;;,.o •••, AUDREYB. HUMPHREY
Commission No. ;ate '; pMMISSI0IQ5'6'db)300817
Commission N
�A ?o= MYCOMMISSIONY eN 77
Z' ;' E%PIRES: March 6, 2023
:og
E PIRES: March 8, 2023
�"•
..• e; ota Pa5lic Underwriters i
• dedThmNatary PuGic Underwriters
For,°
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19