HomeMy WebLinkAboutbuilding permitII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Residential V
Phone: (772) 462--553 Fax: (772) 462-1578 Commercial
PERMIT TYPE: C,ccva�t d w
Address: _ 9144 &e/ -rlprr-A, C4- —�r�? ul L���,IP �L ��
Property Tax ID #: 43 c Lot No.
Site Plan Name: i "-v,,Ls p r ze r Block No. �Q
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Additional work to be performed under this permit- check all that apply:
Mechanical _ Gas Tank — Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: -__ qx_ __ Sq. Ft. of First Floor:
Cost of Construction: $ • Utilities: -Sewer _Septic
Name * �, 1t7AUS 4'
Address: X 44-
G'" k
LM
City/:-_..z(CM _ State:
Zip Code: -_3,L4qg_✓ Fax:
Phone No. "q_ g0.370
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Windows/Doors
Roof Pftch
Building Height:
Name:, AW1117f[a --
Company: M ;t1G of ?.;(W AReal &h'"
Address: Ito B '(orhakJle, Df• De'
City: (hdta,' 46i'064*- llmck/ Stater
Zip Code: 3a93l Fax: 3at-7i7'`Ea—
Phone No i^7 a- 337-
E-Mail'qLum 0-
State or County License 'iq')I"l
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HV/AC is t7,500 or more, a RECORDED Notice of Commencement is required.
NGINEER: — Not Applicable
Name:
Address:
City:
Zip: ---_ - --- Phone
FEF .SIMPLE TITLE HOLDER.
Name:
Address:
City:__
Zip: — Phone: —
State
___ Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City.
Zip: Phone:
— Not Applicable
State:
BONDING COMPANY: Not Applicable
Name:
Address -
City:
Zip: Phone:
WNER/ 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.
t. i-ucia" ;o�i tv rr.ake; no representation that is granting a permit wit; authorize the permit holder to build the subject structure
trtu�lturenPleas=crow salt with pyourr applicable
Owners Association Home Owners randrreview your deed or any aws or and restrictions nts that wh which may arestrict or pplyhibit such
n consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
n accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
he following building permit applications are exempt from undergoing a full concurrency review: room additions,
ccas,:or; St uci.,.ire:;, sw'mrning pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
"WARNI.NG TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
•]'WI:-'E FOP tMPROVEMENTS 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." _
��iinrty� i' �TQd -
Signature of Owner/ essee/Contractor as Agent for Owner Signature of Contractor License Holder
S1 ATE ::IF FLCr.uIL
COUINTY
The F rr-ci ng ir,st. iri -rir was a-Kriovvieciged oc-fure me
this AP day of JWi U e20_20 by
Name o p rson rraldng ,tatement.
Personsll.'v Kn?wr .__ _ _ OR Produced Identification
.iyK of, icienvficat.cr�
Producerd..-.....— --.__ _......_._._._. _. __._...
(Signature o V
otary PubI
Comrnission No.l7(I)„
REVIEWS I FRONT
I COUNTER
DATE
RE'_-EiVED
DATE
COMPLETED
of Florida
Op ►yt I Notary Public State o
? a `t Ashley M Antoneili
STATE OF fLORIQ&, , _ /Q��
t:0UNYY OF � -
ping ills
enc was acknowledged before me
this day of 20% by
Name of person making statement.
Personally Known OR Produced Identification
iype of identificat' n
Produced_-_._.
(Signature of NotaPublic- State -o-of—FloridaSiC 'I,
n"' mmion N/�o. [ �t_SW�•�lV�i�VM
Exk'cpires t0/18I2021 +` ° t
\ VEGETATION Elio' TLE'4 MANGRO�
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