HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application QZ0Z 10 Nnr
Planning and Development Services CISAIa:Ml
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553' Fax: (772)462-1579 Commercial Residential
PERMITTYPE:
PR606SED-IMMOVEME-NT.LOCA"TION.
Address: 4-4 G7 tO -J. V J L L 6' /0,o,A D F,tZT 1 ,,C--fl_C e 3 11,F602-1
Property Tax ID#: '17,-b 2'0 Lot No.
SitePlanName:- <2 r,( PLP'7.13 AND /0 Block No.
Project Name:
DETAILED t. 1- ._''_l�0Tl040F,WQRK:
011E IWO V,5_0 4A, P /,-JS-771-LC;rJC_ Ii/$'Q--v.9 IYII'_G SI:AE5f) '
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CONST-RUCTION"INFORMATION:
Additional work to be performed under this permit-check all that apply:
—M echanical —Gas Tank Gas Piping ^Shutters Windows/Doors
—Electric —Plumbing Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction:l Sq. Ft. of First Floor:
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Cost of Construction:$ ;/_i/4)40. Utilities: —Sewer —Septic Building Height:
-OWNERAE'SSEE', 'CONTRACTOR:
Name -:3-6 i4 N I Name:
Address:—GL-6-1 JY)it L`C' POA 9 Company:
City: r--012:—, Pferz-0-6 State: Address:-.
Zip Code: 3 V-YSZ- — Fax:— City: State:
Phone No. 77-z 5-ZI 6-5-o S Zip Code: Fax:
E-Mail: Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
_LI
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.
SUI#?PLENO'ENTAL ONSTRU.CTION LIEN LAW IN'F4RMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
E City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: i 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 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 COMMENCEMENT."
SJgnatbre of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF I,.,a9t".;'� COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_L day of M J n' .2e , 20/,,1)by this day of 20_ by
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
1
(Signature of Notary Public-S a e of Plorida 0 15N 1, (Signature of Notary Public-State of Florida}
CL M•`
0 CID CL
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Commission No. (Seal) �Y wN ommission No. (Seal)
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11co so O
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REVIEWS FRONT ZONING SU > � PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW R �(Es°� ',� EVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. -;_
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I, the-undersigned, am the owner of the following described property,
- Zr—&0 ? EYP-sSLVi �-�6 I2Q(4j) rott:r.
(Parcel ld#/Legal description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number 20 0 1 acknowledge
that as owner of the above described property, and in accordance with Section
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community WILL NOT be adversely affected.
I further acknowledge that in granting this permit for the development of this property,
St. Lucie County is neither obliged nor liable to provide for, or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
(24'cr—
Property Owner Name(Please Print)
12 L,--
5
ProjeAy Owner Signature
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS_ DAY OF 20 74)
BY WHO IS PERSONALLY KNOWN TO MEQ OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGNATIM11 15fNOTARY VLr— TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
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