HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLc , 60 FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 00
Building Permit Application APR 15 2020
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMITTYPE: 6 )e At-7
.2
PROPOSED IMPROVEMENTLOCATION:
Address: I r01
Property Tax ID #:
Site Plan Name: _
Project Name: _
—irii —r-ic i i r— . t)ryi —
-
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Permitting Department
St. Lucie County; FL
Residential ✓
Lot No.
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _✓Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _720 514 +
Cost of Construction: $ 9, 0c)o Utilities: —Sewer _Septic Building Height: UA
OWNER/LESSEE:
CONTRACTOR:
Name O
Name:
Addresss:161M 13riG11e_ ir. 4Ct
Company:
City: l'n("f�St �L. cL e State:(
Zip Code: "1FR � Fax:
Phone No. 772 83(}4fl30
Address: 191 Cnrd l nn
J R IC.1ce I CLi I
City: Zh h5nrn Stater
Zip Code: 2. O 1% Fax:
Phone No bW G70 �2
E-Mail:kCrFhuCQ1(0f&O0tC.IoLAC1.Corn
Fill in fee simple Title Holder on next page ( if different
from the owner listed above)
E-Mail
State or County License 12.5 A 2, 2,
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.
SUPPLEMENTAL CONSTRUCiiUd LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name: g
_ Not Applicable
i
MORTGAGE COMPANY:
Name:
Not Applicable
Address: '
-
Address:
City:
Zip: = Phone
State::`*L
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
✓ Not Applicable
BONDING COMPANY:
Name:
✓Not Applicable
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."
/�.C97[ 1 / / (1a�
Signatu er/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OFFLORIDq�
STATE OF FLORIDA
COUNTY OF l�Y`i'
COUNTY OF
The for oing inst ent was acknowledged before me
The forgoing instrument was acknowledged before me
this ?day of A&f2 20_,:)V by
this_dayof .20_ by
7Vi—L % F Y l rt c !/ < `/Z r% eI7
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification I
Type of Identification
Produced
Produced
(Signature of Notary P bI State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. tN `kYe; �B.HUMPHREY
Commission No. (Seal)
�. f•f I,ly p� MMISSION#BOS00817
+.., a'.• EXPIRES:
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urrPa6licUndannikn
REVIEWS
FRONT
ZONING
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/ // 19