HomeMy WebLinkAboutBuilding Permit + All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /
Date: Permit Number:
Building Permit Application a o
Planning and Development Services c o
7
Building and Code Regulation Division �3
2300 Virginia Avenue,Fort Pierce Ft 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential 1,000'
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION'...:
Address: � � 1. ..
.Property Tax ID#: ��®�-(p��-Od��'l odd " � Lot No.
Site Plan Name: �- /� Block No.
Project Name: 1/,Yr l 16J/106W c g'j' l-8
DETAILED DESCRIPTION OF WORK
CONSTRUCTION,INFORMATION:
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 Constructions I o Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE CONTRACTO`R
Name olelv ell
f S Name: mac .i i ;
Addres a Q l / CompanA1 �7'
16)
City: Al / State: Addrejff:Zip Code: Fax: City: CState:
Phone No. Zip Code: B Fax:
E-Mail: Phone No 30
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License �•
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 CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City. State: City: State:
Zip: Phone_ Zip:_Phone:
FEE SIMPLE TITLE HOLDER- 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 gr 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
OWARNWC TO OWNE1C YOUR FAILURE TO RECORD A NOTICE OF COMIiiIENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR H4PRDVBKNTS TO YOUR PROPERTY, A NOTICE OF COMMENCMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCIING, CONSULT
JWM"OUR UMXR OR AN ATTORE RECO R NOME OF C014NENCEMENt-
SignIgureor 1% 110-1
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STATE OF FLORInik STATE OF FLORIDA
COUNTY OF Lk LA4� COUNTY OF _15f ju",Lu
The fo;&eing Instrument was acknowledged before me The for&wng instrument was acknowledged before me
this day of 20k by this_&V day ofYVIt-A 2011) by
NaFne of persoemaking statemeName of pens&making statement.
Personally Known tl� nt.011e Produced Identification Personally Known Z� OR Produced Identification
Type of Identification Type of Identification
pro Produced ZO.—
SUSANAD.Mta
MYCOMISSMOGGaM D.PEREZ
EXIMES:ftwiW28.2022
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Commission No. (Seal) CommissionNo. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Oid
lev.21-7119