HomeMy WebLinkAboutBuilding Permit ApplicationMI ICT RF COMPI FTFO FOR APPLICATION TO BE ACCEPTED
Date:
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:
Address:
Property Tax ID #:
Site Plan Name:
Permit Number: Z o V 6
frCE1VED
Building Permit Application JUN 17 2020
ST. Lucie County, Permitting
Commercial
Mr-rA L S H Ep
)DEMENT LQGA710N:
BRTDLEWoop WAY
Project Name: fttA L SHED
ME-T14L 5HFD So x Lt C
Y\0y t Ga lot, 1`Ze l.Any e-
Additional work to be performed under this permit— check all that apply:
Residential X
FL
Lot No.
Block No.
EN(iiNEERED
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 1230
Sq.
Ft. of First Floor:
Cost of Construction:$ 1Y,eOO
I
Utilities:
_Sewer _Septic
Building Height:�Z
OWNER/LESSEE:
Name — OM RCi 5
CONTRACTOR:
Name: KoNFT 78LrsL
Address: ;.SITL 891OLEWOOA LJAy
Company: N�A
City: F02ra r -EECE State:F_L
Zip Code: .1 °I9NS Fax:
Phone No. 7`7�2. —97l — 1113
Address:, ZS-S� r-MEG(IODQ (AIRY
City: Fopm State: FL
Zip Code: 3q 9t/S Fax:
Phone Non 77Z- g7/- 1113
E-Mail: P.[9 aS. Y(�QANlla ® -MATL.66111
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail 0.TI45 , YOAN f gym ! G601
R
State or County License k
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.
City:
Zip:,
FEE SIMPLE TITLE HOLDER: X Not
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
VAme:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: -XNot Applicable
Name:
Address:
City:
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 Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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
WITH YOUR LENDER OR AN -ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner ssee/Contr for as Agent for Owner
Signature of Contractor/License Holder
STATE O=LOAD
STATE OF FLORIDA
COUNTY OF 2
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 1Xclayof 'Lltrt'A— 20a by
this_ day of 20_ by
Name of person make g statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
°"'%U•-. DELANEYGOYETTE
a 'Commission#GG070739
�'
pP Expires February7, 2021
(Signature of -
(Signature of Notary Public- State of Florida )
a+
Commission No. ft-)O13OI (Seal)
l'
Commission No. (Seal)
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