HomeMy WebLinkAboutBuilding permti appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: lI 4�6'�D 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: E L F_ C'_T R_I C/� L-
Address: 5 j- l U - M /�C
Property Tax ID #: 3 C/ —Ly�C - X Lot No.
Site Plan Name: �A1/L//_q/f /�i✓L2 TA- D Block No. �/
Project Name:
_ F kC �/�AL py-s i?ECT1Unl
IL(? �3:k_ COn/
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing — Sprinklers _ Generator T Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
C
Cost of Construction: $ Utilities —Sewer —Septic
Name ['SANK Of- A(C-W 1'1 LZLbL
Address: r�5 15EAT71 F Pk, 5-M .300
City: C =ENVI LL_C State: Se -
Zip Code:`/ld! / Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: 10
Company: Tz,
Address: /0)D,
Building Height:
City: State:L
Zip Code: _��Cf �� _ Fax:
Phone No
E-Mail QC% ,(2c'ol
State or County License
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.
EMENTAL CONSTRUCTION LIEN LAW INFORMATION:
FDESIGNER/ENGINEER:— Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Address:
State:
City:
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
restrict or such
hat which
tlandrreviewyyour any
which is in structure . withdeed for restrictions may apply.
w with applicable
Hlome owners Association
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 uses to another non-residential use
accessory structures, swimming pools, fences, walls, signs, screen rooms and
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
NOTICE OF COMMENCEMENT MUST BE RECORDED AND
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A
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 o wner/ Lessee/Contractor as Agent for Owner Sign Lure Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
�� �--L�C f
COUNTY OF `..1 `c;�, e. COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
20_,by this ay of JUI� _ ZC�U by
this; 1f day of �1�t � �
MCc+rc�
Name of person making statement. Name of person making statement.
,Z
✓ OR Produced Identification Personally Known OR Produced Identification
Personally Known
Type of Identification Type of Identification
Produced Produced
JA 1 %c .__. -yam 10 `IrC
(Signature bf Notary Public- Signatu of Notary Public- St
Notary Public state of Florida i►e' Notary Public State of Florida
�rg�(et E Montepare 4c1a1Qa(et E Montepare
Commission No. t �f`b4imissionGG214990 ommission No. ly missionGGzlas90
Expires 06/05/2022 pwd� Expires 06/05/2022
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW
COUNTER REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.