HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPL'ETO FOR APPLICATION TO BE ACCEPTED'
Date: ZdZ,D Permit Number: 2'004 —00 I
Planning and Development Services
Building and Code Regulation Division
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
IPERMITTYPE:
Address:
Property Tax ID #:
Site Plan Name:
Project Name:
PECEZVED
Building Permit Appli atidftY o 52020
ST. Lucie County, Permitting
Commercial Residential X
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DER'A11ED DESCRIPTJON OfW,ORK;
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Additional work to be performed under this permit -check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters
Lot No. 9
Block No. 3 2
Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 2 F:5� Sq. Ft. of First Floor: Z RT
Cost of Construction: $ 2 3-15' do Utilities: _Sewer _Septic Building Height:
OVtlNEf3/LESSEE "
Name GUI;15ToP1(EIR I'll LAM b
CONTRACTOR .R
Name: CP1eISf0 PN& M LAM 6
Address: 145055 NA9WT4 M
Company:
Address:
City: I%s0YIgIT LLUGIE State: L
Zip Code: ` 4lin Fax:
Phone No. 6 21) � W -Rkcm
City: State:_
ZipCode: Fax:
Phone No
/(I
E-Mail: LAN 6 GN215 E60-)
E-Mail
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License
�a
If value of construction is $2500 or more, a RtcuKutu rvotice of wmmc........c,...., . -•,-••--
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPL'EMu)1`ALG�NSPRU L3�V'ILIEN IAW, (NFCtttMATNON
n
DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name: bA%J6 S aexrw
Eglur- f ING
Name:
Address: 2(od WF_ICI�'A 091tlbS
1Ti'e l
rSu0(a0
Address:
City:
State:
City: Lomwoo.P State:
Zip: ?12"!� 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 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."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Wwv"-'
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this -30 day of P20?o by
this _ day of 20_ by
CHRIs�aPHe;e ,m tramA _
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
RUSSELL COMBS
Public - State of Florida
Notary
(Signature of Notar e' I' $ '• e 9'M811d�
(Signature of Notary Public- State of Florida )
ec My Comm. z ires May 5, 2021
'O'FOF `�' Bonded Mro h N ional Notary Assn.
G G1"'89
Commission No. (Seal)
Commission No.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19