HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COS,- _.. -'TED FOR APPLICATION TO BE ACCEPTED -
12,1
Date: Permit Number:2-0097-0
S=1I -'i I
•
_...._..._�...._._-- RECEIVED
Building Permit Application
Planning and Development Services MAY 0 8 7070
Building and Code Regulation Division
Permitting De artment
2300 Virginia Avenue, Fort Pierce FL 34982 st. L, county
Commercial Residential
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE:
IIP.RC3tSE�,iMRROU£MENT.LOCATIC)N
Address: I VY160' IY; r0( tZP fTQ 3�
Property Tax ID#: 1132-- KO - 00T112000 Lot No.
Site Plan Name: Block No.
Project Name:
oar a)
GONSTRU I t� -N C�VFCU) mATION' -'
._�_.
Additional work to be performed under this permit -check all that apply:
_Gas Tank _Gas Piping _Shutters —Windows/Doors
_Mechanical
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
_
Construction: L10 Sq. Ft. of First Floor:
Total Sq. Ft of
Cost of Construction: $ c9goo _ Utilities: _Sewer _Septic Building Height:
n
01dGNR/� 1:�SBE`
CONTRACTOR
Name
VY�On
Name:
���
Address:.L� t .0 e'
company:
fi
City: r0(r �Q�e� State: _•
Address:
2)4-q4(9 Fax: IJJA
City: State:_
Zip Code:
-7 a,'a)CJ-OL+W3
Zip Code: Fax:
Phone No
E-Mail:
_
a _
(I
Phone No
Fill in fee simple Title Holder on next page if different
E-Mail
State or County License
from the Owner listed above)
-------------
.onenment is required.
L If value of construction is $2soo or more, a KtLVnuC✓ �.....�_ ••••••_..__..--.
If value of NUAC is S7,900 or more, 2 RECORDED Notice of Commencement is required,
M1
411ri
�Tn 1•. �4 L
r, x
DESIGNER/ENGINEER:
Name:
Address:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
City:
Address:
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
which is In conflict with an
structure. Please consult v
e the permit holder to build the subject structure
deed for any restrictions which ma or prohibit such
Y 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
_ ___ .�� w.. nwuutui•lYI�IT»
as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA I STATE OF FLORIDA
COUNTY OF JCOUNTY OF
The forgoing instrument was acknowledged before me
this,, day of �Q� `2020 by
el
Name of person making statement.
Personally Known OR Produced Identification
Type of Ident'jf,ication
Produced GYy—w l _1 C 105k�
N n ► I ov h .' o L , . ,.gym 00
(Signature of Notar Public- State of Florida )
Commission No t- n9 53Y(Seal)
REVIEWS
FRONT
ZONING
SUP
COUNTER
REVIEW
RE
DATE
RECEIVED
DATE
COMPLETED
r
ERVISOR
VIEW
ev. Commission p 00 0W574
yP� ExpiresAu0ust23,2021
OFF�o� 8Qided TNaaudrd N4"$MkM
The forgoing instrument was acknowledged before me
this _ day of 2o,_ by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary PUbIiC- State of Florida)
Commission No. (Seal)
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW