HomeMy WebLinkAboutbuilding permitAll 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:
Permit Number:
Building Permit Application
1. PROPOSED IMPROVEMENT LOCATION:
Address: P 11i e,01e4 1310
Property Tax ID #:
Site Plan Name: i V 6-H &i
Project Name:
a
Commercial Residential xy-
I'f_3 11r000
DETAILED DESCRIPTION OF WORK:
9K41 X ne,o S4*4 a'r b4
CONSTRUCTION INFORMATION:
......................
Lot Flo. 32
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical _... Gas Wank — Gas Piping — Shutters Windows/Doors
_ Electric — Plumbing —Sprinklers — Generator Roof Pitch
Total Sq. Ft of Construction:: ,
Cast of Construction: $ Q ��
Sq_ Ft. of First Floor:
Utilities: _Sewer _Septic Building Height.
OWNERAESSEE:
CONTRACTOR:
Name II z A AyD i5 i P—VCC �l�� ti I ut
Name:—tfA'65
Address:_ �t+gZ1 Ok' 11 A-pV K
Company: 11� —Vt.�
City: �.k ��� _- 5tate:l�? �
Zip Code: Fax:
Phone No. �Q --(- - 0
t� �Vkib�l`W C,k
Address:.Z7 �Z. �vt/
City: state-_rt.
Zip Code: 3518 y _ Fax:
Phone No 77;�' 2M q737
E-Mai1:Tact It "m cic-y C: s
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Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
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E-Mail ! cp
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State or County License lsbq
if value of construction is $2!iO i or more, a RECORDED Notice of Commencement is required.
If value of HVAC is S7,500 or more a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Marne:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable I BONDING COMPANY: X Not Applicable
Address:
City.,.._.... ---
Zip: Phone:
Dame=
Address:
City-
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. Luciepuntymakes 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 Horne 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 ail respects, perform the work
in accordance with the approved plans, the Florida Building Conies 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 IIMPROYEMENTS TO YOUR PROPERTY- A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE .LOB SITE BEFORE THE FIRST INSPECIROM IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCT ME]uT'_"
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF___ GLfi
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of . 20— by
thLQJ S day of 6a 120 20 by
Yi
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 r 1`�, r r !`s It C9
,,aJs o
(Signature of Notary Public- State of Florida)
(Sign to of Notary Public- tate of Florida
Commission No_ (Seal)
Commission No. (Seal)
'` 3 -c O
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
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COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
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DATE
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RECEIVFzD
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DATE
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COMPLETE[)
Rbv. 2/7/19