HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 ZO 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
PERMIT TYPE: AC 6,h f _ e�
PROPOSED IMPROVEMENT LOCA ON:
i -1 C-1 A I F= -Rr-w, Q rl . D,r- J- 1 ,-, �, �:-r
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PropertyTaxID#: 3Li (9-!57C -003Z `OCC - e,- Lot No.
Site Plan Name: kt ye t- Block No. %6
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 _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 4)302- - Q�
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name to beA J i Z
Name:; Mcw-+t'
Company f Ai V�?(VfKb(jdt
Address: (l? KA--- r&6VC-1-1 V-6
city: i- L,-7cAc- State:
Zip Code: 34CATS Fax:
Phone No. 17.2 _ y 7 y 2-
Address: 145�7 SAF, +
City: P"k j�. L.,icee.
Zip Code: 3"s Fax:
Phone Not-71-33W-222-�
State: PC -
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail lY\6,V t+ -2 -L -C hide. f
rut'noe'.("
State or County License CAL /'
--meq
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.
DESIGNER/ENGINEER: — Not Applicable
Name: MORTGAGE COMPANY: Not Applicable
_
Address: Name:
Address:
City: State: City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ 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 and posted on th�jobsite before the first inspection. If you intend to obtain financing, consult
witty lent r or an attorney befl a commencing work or recordinamnur Nnfif-a of rr%mrms%..,.,s
as Agent for Owner
STATE OF FLORIDA STATE OF FLORIDA w
COUNTY OF � 1 Lau c' COUNTY OF S •T
Sworn to (or affirmed) and subscribed before me of
6 Physical Presence or Online Notarizatinn
this day of
2020 by
REVIEWS I FRONT,ZONING
COUNTEREVIEW
DA
Sworn to (or affirmed) and subscribed before me of
F/ Physical Presence or Online Notarization
this day of 2020 by
Name of person making statement.
Personally Knowny OR Produced Identification
Type of identification
Prody.ced
f
Signature of Notary Public- State ofr DIANE cot
�^ Notary Public - stat,
Commission No. `q Commission N GG
My Comm. Expires M
Bondedthreagh National
PERVIS
S ANGRO
REVIEWOR REVIEW I I PLANSV EV EWON I s REV EWLE M EV EWVE
2024
Assn.
Name of person making statement.
Personally Known i1 OR Produced
identification
Type of Identification
Produced
Signature of Notary Pu
,
ti►° r '""••-111ANE
Commission No. —�y
COLE
Nota b Sta te of Florida
_
'•..•OFA°°'
coif GG 961089
My Comm. Expires Mar 14, 2024
REVIEWS I FRONT,ZONING
COUNTEREVIEW
DA
Sworn to (or affirmed) and subscribed before me of
F/ Physical Presence or Online Notarization
this day of 2020 by
Name of person making statement.
Personally Knowny OR Produced Identification
Type of identification
Prody.ced
f
Signature of Notary Public- State ofr DIANE cot
�^ Notary Public - stat,
Commission No. `q Commission N GG
My Comm. Expires M
Bondedthreagh National
PERVIS
S ANGRO
REVIEWOR REVIEW I I PLANSV EV EWON I s REV EWLE M EV EWVE
2024
Assn.