HomeMy WebLinkAboutBuilding permit application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (ZECENED
Date: I Permit Number: 2_0o2ote
- fie , yr- uE1ee4J nment-
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Building Permit Application
Planning and Development Services
Building and Code Regulation Divis..ion Commercial Residential (�
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (77 2)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
PRPsaovETLoc�T � u• „
Address: D 9014 H t PLEwnei
Property Tax ID#: Ij�` /�. 1 S- (n_b"7 0-no C Lot No. 7
Site Plan Name: cy ?i A2tL Block No. 919
Project Name: LW of
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6L.-t-Ts /LVD W44r)`D i-Rk--_2P -a cTU.Week 1 L240� iFtti)f=y ®,u (-LAT &�2C- AIZ�
New electrical Meter Second Electrical Meter
XWST 10
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Additional work to,be performed under this permit-check all that apply:
_Mechanical Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond
_Electric -Plumbing _Sprinklers _Generator X Roof IZ Pitch '
ZGpo Stfu�htc�il F lfk-i
Total Sq. Ft of Construction: W-10 517 J Sq. Ft. of First Floor:
Cost of Construction:$ I (, 3 Co- Utilities: -Sewer -Septic Building Height:
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DUtNER/LESSE,E..
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Name: !S ej-Et i C'.ASr,�W o:;:
Address: `7QD�} 14i.g15GLLS tZp Company: �g�r�,-�u�!'7���C Cit
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City: Stater Address: X771 0L�-1ai.»Pz- A-yc
Zip Code: -3q.6j5-_( Fax: City: Ex Stater
Phone No. --7-7-2-
!5'3,2- �Jq3S::�: Zip Code: 3Lfatg7i Fax:
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E-Mail: Phone No "272 Zlfo- 5?-e)4-7
Fill in fee simple Title Holder on next page(if different E-Mail C.4S.—a�•+r7 t.4aL/ ao�=u.� hwt �t,, wCr
from the Owner listed above) State or County License Cccc ;-5D573 J I
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If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
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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 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.paying twice for
improvements to your property. A-Notice of Commencement must be recorded in the public records of St..
Lucie County a ted on the jobsite before the first inspection. If you inte btain financing; consult
with IencJ0 an attorney before commencing work or recording o r ce of Vommencement.
Signature of O essee/Contractor as Agent for Owner Signature o cense
STATE OF FLORID STATE OF FLORIDA
COUNTY OF �Lue-(-e- COUNTY OF
SwQr/nto(or affirmed)and subscribed before me of Sw�m to(or affirmed) and subscribed before me of
Physical Presenncc or Online Notarization Physical Presenter Online Notarization
this L_day of JU 20 70 by this I day of LJ U I 20 Z by
n A 04_c'40n(2 U-CLi Su��
Name of person making statement. Name of person making statement.
statement.
Personally Known / OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Type of I entification
rodu d Produc d
(Signature of Notary Publi (Signatur of Notary Public-Stat of lorida RENEE PHILLIPP
RENEE PHILLIPPE ,�/ � pr
'Qa n� °ublic,State of Florida 'l ( a w �i �otary Public,State of or a
Commission Nb o �YY Commission No. _ al Commission#GG 1.79 7
_Y Co%ission#GG 179276
3 -My comm.expires Mar.4,2022 R My comm.expires Mar.4,2
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED:
DATE
COMPLETED
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