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HomeMy WebLinkAboutBuilding Permit Application e- Cr. AoL All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: '7 Permit Number: Z r907 D Z.S 5' 0 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: NC �f S L N Ce 1110 OPOSE© I!M R,7 WR @ I M i R W IN LOCATION: Address: 7—(3f� S (pvr/t A-l I- — PropertyTaxlD#: I`}O? _ � 1' ©yO ` ��� Lot No. Site Plan Name: Block No. Project Name: ► t\",,,Aety, tT P�L� DETAPLED ©EASGRIP IT]IOINS O'FAWN,OR Rest '3&ry ce. CONSTRUCTIONN'FORM TION: Additional work to be performed under this permit-check all that apply: `lAMechanical _Gas Tank _Gas Piping Shutters /✓Windows/Doors v Electric ZPlumbing _Sprinklers' _Generator V Roof 6 i Z Pitch Total Sq. Ft of Construction: - �� Sq. Ft. of First Floor: ( R q O Cost of Construction:$ /�Q;WP0 Utilities: _Sewer _Septic Building Height: O ;NE /LE�SC . CONTRmill A DR: Name ����1� (t�Nc.1 Name: S ee��� A d`w1 Address: SS®J L`c ko �r cuts Gc&c.le UJ e� Comfpan.y: ' ®Ar'c.�e city: fie 2Ck State: l Addr s:. .S �'�° Zip Code: 3$Js Q Fax: City:, eQ , R t��_ State. Phone No. ;�O 3- g 3 i- S s 7 ode: a°i Fax: E-Mail: /V{5Z71v S e,=0L• &�-� P on No D' 3 "' Fill in fee simple Title Holder on next page if different E-Mail 7foZ from the Owner listed above) State or Co Licens,¢ 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: 9)6kav 40 4jo_LP Name: Address: i 05 ZS ill A, e Address: City: cI e.s we 6 vt4- State: City: State: Zip: t t Phone 1-1 oT ` L-3- Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: -5jeCe, A.kA er-4A q ol Name: Address: fs ac UG-fd er ev e S 41Q�Ie We -Sf Address: City: fc a-Ac- fierce City: Zip: 1'5�fcl SI 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 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 LEND R AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." <5e Si ature of Owner/Lessee/Contractor as Agent for Owner Signature Contractor/License Holder STATE OF FLOR DA STATE OF FLORIDA COUNTY OF_ COUNTY OF The for jwas acknowledged before me The forgoing instrument was acknowledged before me this ting instru en day of �U 1�I 20Wby this day of 20_ by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced L L_ Produced (Signature of No ry 1wPu c- tam 9 '4PNIELSEN (Signature of Notary Public-State of Florida) =o'Pffiy ;State of Florida-Notary Public Commission No. Corn miss io G 207484 Commission Expires Commission No. (Seal) 511" f��\�` y June 12, 2022 ��f11111� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE " RECEIVED DATE COMPLETED Rev.