HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: Permit Number: "400
l�tan Kid'
- �- Building Permit Applic tion
APR 2 S 2020
Planning and Development Services
Building and Code Regulation Division Perm lttingPepartment
2300 Virginia Avenue, Fort Pierce FL 34982 ��'
Phone: (772) 462-1553 Fax: (772) 462-157B Commercial R Sld9htihLUCI County, FL
PERMITTYPE:
ROPOS MP O E ENT LOGA ON
Address: 3 /O S u 5oN 6A&(9' P(Z7J
Property Tax ID Soy oi%/`DOD`s Lot No. i76
Site Plan Name: Block No.
Project Name: (S LC
DET LED DESCRIPTION OF WOR :
7!7/F AA vt)
GONS UCTION INFO MATION:
Additional work to be performed under this permit— check all that apply:
_Gas Tank _Gas Piping _Shutters ✓-Windows/Doors, f
_Mechanical
✓Electric _Plumbing _Sprinklers _Generat6r',7�, .!Roof og'!/z- .' Pitch
Total Sq. Ft of Construction. /'xIL /DO > Pt Sq_Ft. of First Floor:
orJ
Cost of Construction: $ 9 1 00 s ^moo Utilities: _Sewer Septic .Building Height:
OW ER LESSEE:
GONT CTOR:
Name
Name / A/!EL le 67O
Address �i 0 $C1n/
_
Coritpany:.4'
City t'�� Statet>!, v �
Address , - >
City " j r`' : iA State:_
Zip Code: F ��%� Fax:
Phone No. 6K,32 s- 11537,
Zip Code:
E-Mail: CZ>UXFU (d �61ty-o . C1r>VI
Phone No
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.
0
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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
N
as Agent
STATE OF FLORIDA�% J ,
COUNTY OF �B
The JI instrument was acknowledged before me
thi day of. 20.>by
Name of person making statement
Personally Known OR Produced Identification
Type of Identificat'
Produced -4 (A �l r • ' 1 ,
Signature of Contractor/License Holder
STATE OF FLORIDA.
COUNTY OF
The forgoing instrument was acknowledged before me
this _ day of 20_ by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
(Signature of Not HREY // (Signature of Notary Public- State of Florida)' .
A. :>{ MY COMMIS ION#GG3066t
Commission No. :,,:Sq>$�h6,2023 Commission No. ..(Seal)
EXPIRE • wtlicUnder+�teIS S . .
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE " MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
RECEIVED
COMPLETED