HomeMy WebLinkAboutBuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -7---l- 6 - 2.0
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (77 2) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
X
Address: 1197Y Qca.l i % Ave-
Property
veProperty Tax ID #: Lot No.
Site Plan Name:
Project Name: Fai
Block No.
ll
A t i • Me! - — ----- -- ----- -- • ill - MVWli
New electrical Meter Second Electrical Meter
Additional work to be performed under this permit - check all that apply:
_Mechanical
Electric
Gas Tank
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 1, D0T O
_ Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Sprinklers e Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
Name_ k!T ne a; Id ina Ca,.n
Address: Flc>op U S 1.
City: Pet $t 1-.e;e- State: r 1 -
Zip Code: 34gS I Fax:
Phone No.
E -Mail: bGvtrl y 6 S PanaA 1.q1{c5 1 clam
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: exli i
Company:_Ar a4 r El«}rie_ GLC.
Address: 14(.0 SW &Lr - y& v -
City: Poll S t. L�.GV P j State: FL
Zip Code: 34Q-5'; _ Fax:
Phone No 772 701Y-91466
E -Mail "Lkri5 a f'OcL^i /4kj: —ed
State or County License CR 3 1 7 -5-
if
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.
"DESIGRNEIENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
State:
Address:
City: State:
City:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
Zip: Phone:
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 Counttffyyff makes no representation that is. granting a permit will authorize the permit holder to build the subject structure
eAsssoAssociationions maychh rict aprohibit such
at ori and .review your de d for any restrictants
may
s�ucctture. Pleasecconsultwnh.youcraHome Owners
In consideration of the granting of this requested permit, l 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,
screen rooms and accessory uses to another non-residential use
accessory structures, swimming pools, fences, walls, signs,
WARNING TO O`WkER: 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 the jobsitebefore the first inspection. if you intend to obtain financing, consult
with lender or an attorney before commencing work
or recording.yop.r Notice of Commencement.
t
Signature of ner/ Lessee/ o rador a ent for Owner
Sign"ofco dor/License Hol r
STATE OF FLORIDA
STATE OF FLORI J
COUNTY OF I
�
COUNTY OF
Sworn or affirmed) and subscribed before me of
Sworn Ig (or affirmed) and subscribed before me of
Online Notarization
Physical Preseo Online Notarization
this day ofn Y 20 Wby
'1Physical Presen o
this day of s 20 jby
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.
Produce
(Signature of Not Std I
(Signature A LI rida )
STATE OF F ZA
Commissi STATE OF FLORIDA (Seal)
N
Commission No. GG
kPa6262780
Expires 9/26/2022
b 1 Expires 9/26/2022
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
REVIEW
MANGROVE
REVIEW
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.