HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED \
Date: Permit Number.
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Building Permit Application
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 Residential _
PERMIT TYPE: (2-E
VQASBD I'MPRO EMENT LO ATlON4
Address: -1'i T<o S• 3 -n S'C C i !F 3'- q q,-1
Property Tax ID#: :7-Li l.-? 2 -(�2 C)Dd j non - O fy'��6 trr,>%o tit 3w Lot No.
Site Plan Name: p2�S �o��,cX Block No.
Project Name:
DETA!'LED DESCRIPTION OF WORK.
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117000
HT NS 1NFORMA ION:
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping —Shutters _Windows/Doors
_Electric Plumbing _Sprinklers _Generator ;X Roof Ft,as.z Pitch
Total Sq. Ft of Construction; ��n Sq. Ft. of First Floor:
Cost of Construction:$ 2 4 - Utilities: —Sewer _Septic Building Height: l s-ca�
OWNBR/LESSEE: CONTRACTOR: 1111
Name 1guuac%L 2 A,3ri r L-%-C- Name: S:M2Sje,`i (-.4sr'50�uae .
Address: 36S5D cam, �c��„�, ���,�., {�� Company:.C-A-6-u&,s&c&A.,, 2mar�u
City: Fc p ttna c State:r-nL Address: 5'2-7.L
Zip Code: '49!1�� Fax: City: 1( State: �7-L
Phone No. -1'22 3r4 Q��( Zip Code: Fax:
E-Mail: Phone No 772- 2-(d,-8D!y'7
Fill in fee simple Title Holder on next page(if different E-Mail ,VGwc c c
from the Owner listed above) State or County License Z(arS-s7 D Qj
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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UPPLEM'ENTAL CONST SUCTION LIEN LAW t F't ,A I
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,.I do hereby agree that I will,in all respects, perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON T JO SITE BEFORE THE FIRST INSPECTION. IF YOU INT ND TOO NANCING, CONSULT
WITH U ENDE N ATTORNEY BEFORE RECORDING YOUR NOYKt OPCOMMMENCENV'
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Ho
STATE OF FLO$L A STATE OF FLORID
COUNTY OF C)t lAXI.e COUNTY OF�(..()eLe
The for PP�.�g instrum nt was acknowledged before me The f1o�r�ng instrument was acknowledged before me
this f'�"day of 2t)by this lD_day of SUe 20�y
IP-Ve
Name of personmaking statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identi ' ation Type of Identification
Produced Produced
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( g ture Notary Public- I ri a (Si nature f Notary P b = IONA JIh1ENEZ
_ otary Public,State of Flo id Public,State of Florida
2 Commission#GG 92121 Commission#GG 921213
Commission No. 3 SY1�aF�mm,zxpi�As October 3, p�� mission No. �1y ea(i5�� fres patpger 8,
r .A: .._: � ... 2023
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.