HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I I l I�� �h _ Permit Number:
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 > '
PERMITTYPE:
PROPOSED IMPROVE IVIENT L1OCAT�I�O�N/:
A.d����• f) Ar-\ .D -
Property Tax ID #: 1 y�_5` Co (OLA — n�)v
Site Plan Name: \ n�
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
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:
Cost of Construction:
Sq. Ft. of First Floor: _
Utilities: —Sewer —Septic
Lot No.
Block No.
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name \C\mPS-�'1
Name:
Address: WGa1 w DOCS✓ 0- Ne—
Company:
n
City: ���'�C lir' Y� ��
Stater.
\O_
Address: \c%lU 1,�
t�\�SUX�u4 -
Zip Code: Fax: Fax:
City: rA . i"tE.rCa.
State: k-� .
Phone No.
Zip Code: .3 L O(k% Fax: t1tll-4161Y_S
E -Mail: S1m ScY"C( Y1 C1J5C`_\CyyLA
, WOE
Phone No LAI 0\-��J
E -Mail
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Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or ounty License
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requirea.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
OWNER/ CONTRACTOR AFFIDVIT: Application is heresy maae io ootaul a Pt[ 11111
— - -- -- - - -
DESIGNER/ENGINEER:
— Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
STATE OF FLORIDA
�� I_UC
Name:
Address:
COUNTY OF , tom,
Address:
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
State:
City:
State:
City:
Name of person making statement.
Zip: Phone
Zip: Phone:
Personally Known OR Produced Identification
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
(Signature f otary Public- ate Iorl�g,an, public state of Florida
Address:
Margaret E Montepare
Commission No. mmisslon GG 214990
Address:
5 0610512022
W p
City:
City:
REVIEWS
FRONT
ZONING
Zip: Phone:
PLANS
Zip: Phone:
SEA TURTLE
MANGROVE
_J. aL..
.. ...1. .. ..A ir•r4o 11 Linn 9c inrllrAtprl
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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 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
.TTAi1\ICV cccnnr nrrnnn!NG YOUR NOTICE OF COMMENCEMENT."
Vr/IT M YOUR UNDER OR AN A I I11�, L I u�■ v.�� .
r
— - -- -- - - -
Signa 4��fOwner/ Lessee/Contractor as Agent for Owner
Sign to of Contractor/License Holder
STATE OF FLORIDA
�� I_UC
STATE' FLORIDA '
COUNTY OF �1—UL�
4'
COUNTY OF , tom,
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of 20L by
this 1 j t, day of _-�L I _ 20 by
f +h CL,
IL �� LSA a—
Name of person making statement.
Name of person making ssttatement.
Personally Known OR Produced Identification
Personally Knowny OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature f otary Public- ate Iorl�g,an, public state of Florida
ignatur f Notary Public State
Margaret E Montepare
Commission No. mmisslon GG 214990
Cl ��lik Notary Public State of FI
mmission No. C i� 1i q �' ea�i;trgaret E Montepar
5 0610512022
W p
My Commission GG 214
Expires 08/05/2022
a w
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2177ly