HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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:
Address:
Permit Number:
RECEIVED
DEC 2'g 7019
BuildingPermit Application Permittln9 De a pp St. Cucle Contyent
u
Commercial 'Residential ✓ "
Property Tax ID#: 3403- SO -D247 Deep-4 Lot No.
Site Plan Name: 0/+ r r Block No.
Project Name: r0�
Additional workto be performed under this permit- check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters t,Windovds /Doors
YElectric _Plumbing _Sprinklers _Generato.r'\ Roof Pitch
Total Sq. Ft of Construction: /Sol Sq. Ft. of First Floor: /}may
Cost of Construction-$ 00o Utilities: _Sewer ✓Septic Building Height: S- o"
OWNER/LESSEE:
JCaNLTjKACTQR7E
Name 4 °✓ n r
Name:_ 7 mg"
/
Address:- `s A G g s
Company: . o
Lelpo
City: / 7 (r j pl L� State:ilt74
Zip Code: Sz Fax: �—
Phone No. 7r- Z D- /S
'Address:;
City; State:_
Zip Code: 'i Fax:
PhoneNo�'
L
E-Mail: t✓IDYF&T GOYv�G(y5 Y1 PiT
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E Mail ` a
S.tate`or.County License
If value of construction is $2500 or more, a RECORDED Notice of Comioencenient is required. '
.- a I,
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: Aro44 �Tovli c . Lx�-
"&_
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: Solo D04 ware +4ae
Address:
City: State: PZ_
Zip: 349So Phone 744-&- 77S1
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Appli ble l
Name: MA!"A'o, 14e �$(�-i:ntar
BONDING COMPANY: _Not Applicable
Name:
Address: tr .
Address:
City:,Ff- ierc-,e. I^L 314- 82
City:
Zip: 3tJ%?_ Ph e: 77 2— 33 2.—o 14 I
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 OwnersAssociation and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree tliat 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,edditions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another noh-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: •
Signat a of Owner/ Le ontr as Agent for Owner
Signature of Contractor/License Holdei
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF S/— / " ,
COUNTY OF
Thie forgoing instrument was acknowledged before me
The forgoing instrument wZanowledged before me
this Z(,-n day of �¢L 20 L by
( �J ����Gl�/f
this _ day of 20_ by
Name of p rson making statement.
ng statement.
Name/Kno
Personal ly,Known C7L OR Produced Identification
PersoOR Produced Identification
Type of Identification
Type
Produced
Produ
xLi�
— — �_W�v
otary P lic- State of Florida)
(Signature of Notary?
, `s•+oy
(Signature of Notary Public- State of Florida) ' y.
8 jY
Commission No. (Seal)
?:=
Commission No. (Seal)'
-
I
N
n^
�3mm
REVIEWS
FRONT
ZONING
S
SAX
PLANS
VEGETATION
SEATURTLE.
MANGROVE
COUNTER
REVIEW
ff�/o m
REVIEW
REVIEW
REVIEW
REVIEW
DATE
2'a ri
RECEIVED
2
oe'av
mo Z
DATE
1A
COMPLETED
NX m<
7e—v277715
0
o
n