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HomeMy WebLinkAboutBuilding Permit Applicationr� i FrDate: LICABLE INFO MUST o COMPLETED FOR APPLICATION TO BE ACCEPTED �oZ /to . / 1 Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort pierce FL 399B2 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT TYPE: '� — GkS Address: c(e03 /V. Q. T of i flt—A C7r' PropertyTax ID #: YY3(0 ^ , O I — CID — O00 — Site Plan Name: ► 1F Z , AQ � FAA Project Name: Wii.L AA4 F ntQr.AJ £ A-.i Lot No. VP Block No. 1.urivsl,KULWI; NJNFORMATION•': z ; Additional work to be perforrtEfir r .0i per check all that apply: _Mechanical _ GasTTaannk� Gas Piping —Shutters _ Electric _ Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: Sq. Ft. of First Floor: _ Cost of Construction: $ 1�3 foe Utilities: _Sewer _ Septic Windows/Doors —Roof Pitch Buildine Height_ rO /NER/LESSEE : E : ;,y 7 i ti : ti , ,R� Name__ fllrAN F /(aRC�An/x: i"C©NTRAfCTORy* Name: Addr U-1, /1 . t,�. V y/ f i �r City: _ � C'>,iY State: _ Zip Code:3y 0 Fax: Phone No. a- uL Company: rJTY o •) � Address: $W rJ la City:7±1K CITY State: F , Zip Code: 3111 Fax: Phone No IL .Z' �� � 00 E-Mail:MCi '• 1"Fie G NALoeCOAk Fill in fee simple Title Holder on next page -(if different from the Owner listed above) E-Mail[,\ L OtlO State or County Licens p — 9 -� If value of construction .cuwmena ii requirea. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. COMPANY: — Not Applicable Address: Cam' State: Zip: Phone - BONDING COMPANY: _Not Applicable Address: 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, structure. Name: — Address: City: State: Zip: Phone FEE SIMPLE TITLEHOLDER: Not Applicable Name: — Address- city - Zip: Phone: for andpcovenants that to build or prohibit such deed for any restrictions h whicmay 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 FMST MSpECnON. IF YOU IIUTENO TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTK-F nF rnNucurruc.,: >, no ISignatu f Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF- The oin In m twa ckn wled before me this day of r C� 20 by Name of person makings ement. Personally Known X OR Produced Identification Type of Identification Produced (Signature of Notaryu d,e (� ANY REDDIN Commission No State of Florida -Notary Public Coml )on # GG 190282 My Commission Expires February 26. 2022 STATE OF FLORID i AE COUNTY OF The fawning in t wa ckn wledge before me this day off 20_M by :Q L,w Name of person making stat4ment. Personally Known _ Y OR Produced Identification Type of Identification Produced (Signature of Notary Pub] -fit ly,p Fog I 'TANY REDDIN State of Florida -Notary Pub Commission No. - Co $ ion a GG 19028: FRONT ZONING REVIEWS I EGE COUNTER I REVIEW ' I SUPERVISOR I REVIEW PLANS I -TATION I SEATURTLAN REVIEW E MREV ROVE IATF