HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETE61 OR APPLICATION TO BE ACCEPTED U
Date: ���"`�� Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE: <5V\-�ia��
PROPOSED IMPROVEMENT LOCATION:
Address:
RECEIVED
Building Permit Applicat on NOV 2 2 ^1919
5T. Lucle County, Permitting
Commercial 4"' Residential /
Property Tax ID #--r�-�� ^ '"`
Site Plan Name: L .5}e 'e 41
Project Name:
- WrJ9� Lot No.
Block No.
-,Ak IS I S . 1JA-eVbo vs—t3=A!1�+140A w V+-%
CONSTRUCTION INFORMATION: 'i �„ " k—' Y ,, r� i — " — 1"
Additional work to be performed under this permit— check all that apply:
_Mec ical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing ' _ Sprinklerrssp J'� _ Generator
Total Sq. Ft of Construction: (Z X66'tr�'I • Sq. Ft. of First Floor:
Cost of Construction: $ _. 4;7 0'" ,ft Utilities: —Sewer _Septic
Windows/Doors
Roof Pitch
BuildingHeight:
OWNER/LESSEE:
CONTRACTOR:
Name Q!! N /J o4W
Name: : YLt 1411/
Addres :
Co mpa A I N U ma
tie
City: State:7ff[Addres
Zip Code: Fax:
Phone No t' O CD
:. czcq S • Qt=R4A1 Vol
City: .2h.Ii /Y, State:
Zip Code: O Fax:
Phone No" f17 3O3
E-NIaiI:�C Qom— 01 CP
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail `A11 tyNFl L SO U d!
State o County License G e, Sc) '10
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.
SUPPLEMENTAL CONSTRUCTIO N LAW INFORMATION:
DESIGNER/ENGINEER: of Applicable
Name:
MORTGAGE COMPANY: _ of Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable
Name:
BONDING COMPANY: _ of Applicable
Name:
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 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 andcovenantsthat 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 QBTAIN FlNANCING, CONSULT
WITH YOUR I FNDFR OR AN ATTORNFY RpFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature'o ssee Contractor as Agent for Owner
ZZIDA
Signature o Cont j Cfdense Holder
STATE OF
STATE OF FLORIDA
COUNTY OF S-g
COUNTY OF
The forinstrument was acknowledge before me
as
The forgoing instrument was acknowledged before me
aa.day N J
this day of 00 20_ by
this of O 20A by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identificlon
Type of Identification
Produced �' L.
Produced
(Signature of Nota ublic-State of Florida j
(Signature of ° o
:'Siciblic- MSS
CMBSI00022o2a
Commission No..Baaaro. �MprytE G1VENS0�
022
ommission N -.* Y'l CjGPIRES: Decembe`,75 ;quo
.aFrV?`wndedihru Notary Publ titers
ry
"7iu"••.. ISSION#GG
M'f COMM D m "is.20201e
,,.
REVIEWS
�"
FRONT '
ndea
; I
mNoleN
ISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev.2/7/19