HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE Co.iIPLETED FOR APPLICATION TO BE ACCEV r.:J
Date:
Permit Number: ( x 63 " DoS6
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
PERMIT TYPE:
Address
!=
Residential ✓
Property Tax ID #: Lot No.
Site Plan Name: wnL)M0J.3 /(SLAAJO Block No.
Project Name: 4e-".AVIJl A
q l Fc,ic EFyC7C-o3U gu F06 2 iv >�iGrJi2 ROD L- / 5,P4
Additional work to be performed under this permit -check all that apply:
Mechanical
Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Gas Piping _Shutters -Windows/Doors
_ Sprinklers _ Generator _ Roof
Sq. Ft. of First Floor:
Cost of Construction: $ %Z COD, 00 Utilities: —Sewer _Septic Building Height:
Name VE.J677A>J AD"AJ /,g'1)2A7ZOAJ LCC
Address: 'WO0 W. f2AC C Er2 S
City: A41AMI _ State: ja,
Zip Code: Fax:,,..,
Phone No. 174"; "
Fill in fee simple'ritle Holder on next page ( if different
from the Owner listed above)
Pitch
Name: A✓-A4A/JD0 2p-fS
7vLeDD
Company: A27a2 6'O0.STaOc9
7O-J UCC
Address: /3360 SW 40
ST
City: a4/AA4(
Zip Code: 93 11-57
Phone No -796 - 3y-!�
State:
Fax:
—385-5-
E-Mail 1 44ZSIDdeetba�Yct(1CD.ep,•n
State or County License
aJ` ( `i'3
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.
NEER: _ Not Applicable I MORTGAGE COMPANY: _ Not Applicable
Addl
City:
Zip:.
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Address:
State: City: State:
Zip: Phone:
Not Applicable
BONDING COMPANY:
Address:
Zip: Pho
_Not Applicable
OWNER/ CONTRACTOR AFFIDAVIT: 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 IMPROYEMENTS 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."
x
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of ContratAr/License Holder
STATE OF FLORIDA pp
STATE OF FLORI
COUNTYOF C
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this�dayof2t1� by
this�Qdayof irOc� 2 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification V
Personally Known OR Produced Identification
Type of ldepfication II
Type of Identification
,
duced � v
Produced
pp BOO" ! DANNA COLON
+V-ova� K—
Commission k GG 250804
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(Signature of Notary Public-Statg� [[jdagPIAES,August 20,2022
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(Si nat of Notary Public- ate of Florida
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGET
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev.c/i/19