HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 60-0'910010 �s ';EF,' .. rmitNur '
�
_
No APR 9 - 20 c20 � (li
Building Pe Application
Planning and Development Services i3Y:
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-1578 Commercial Residential t/
PERMiTTYPE: 5N6 L e_ F'fif i i1 4 R2Sf � e.nce,
,RROPpSE,D,I(VIPROV�M�NTL,OCATION
Ty
. . ,,.,,,�.E:, , ., 7..r€,,s,.,ti.,
Address:, L
Z) WI r,!5 G
Property Tax ID #' 315,3q " 5� - EJC �IJ 5 ' Lot No.
Site Plan Name: Block No.
/l
Project Name: K I BAR
,
c
°
S l
KCA5 161
encFl-t e -A' rL u*
=5
5 G
G
`�CONSTRUCTI'C+N�INFORIVIATION tc'* • '-"' ,: ; N,'; r' r � y�',�','ty, t,'' ,, E,. ,<.�� s !,.
Additional work to be performed under this permit -check all that apply: /
Mechanical ✓Gas Tank �Vas Piping _Shutters Windows/Doors
/
Electric _pllulmbing _Sprinklers _Generator V Roof Pitch
Total Sq. Ft of Construction: 1"1CS ovi A 1 1 riofJ Sq. Ft. of First Floor: W o f
Cost of Construction:$ Utilities: ✓ewer. _Septic Building Height: 3.r7
WAIL- FPUA
OWNER/LESSEE
CONTRgCTS®R c x < +'
Name:` � e 11 PV) -D._ -IeWnM e
Name QA!M d 5HR1111.
Address: AWN ZS1an Tone.S CV
Company: 6
US'
x.'5 �
City: ftEn s en & 4 G j state:
Zip Code: Fax: —
Address: 400 515 QQA0 B OD *-14465
City: SMart _ _ State.—
Phone No. 1%-- Alo% ONQQ
E-Mail:_6N P--io kf g 056orn-eng,
Zip Code: 3NggN fax: —
Phone No
E-Mail t—MQX1e,!A 6Z 21 R HO W es . COM
Fill in fee simple Title Holder on next page (if differen
from the Owner listed above)
State or County License C, 6C 15 0'10 509
If value of construction is $2500or more,a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a,RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not
Name:
Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
1 certify that no work or installation has commenced prior to the Issuance of permit.
r. i... :,, r .. ... ,.. a .o.n"refine riot to nr.nHna a nermirwill authorize the nermit holder to build the subject structure,
In consideration of the granting of this requested permit, I do hereby agree than will, In all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
"WARNING: TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE .BEFORE THE FIRST .INSPECTION: IF YOU INTENDTO OBTAIN FINANCING, CONSULT
wiru vnim r rwnvo nD. AM ATTnDMFY RFFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Agent for Owner Signature .ofContractor/License: Holder
STATE OF FLORII A STATE OF FL(ADA
COUNTY OF /il�/ZT//1' COUNTY' OFNiRt:t�rirl
The f nginstrum as -a knowledge before me
thisdayof 20 y
<5174g 1 Gf/?l Pflf2
Name of person making st ement.
rsallvlfnnwonOR Produced Identification
Produced
(SignatVrofNotary Public -State of F166da')
Commission o. gmbd(6Rnl$
Lorf A Moxley
M CoaunlWo0(1026148
xp M
REVIEWS ERVIS
COUNTER REVIEW REVIEW
The fo Ing instrumerry�� s acknowledged before me
this day of /-t` AU .20,Xby
ire P µerr Lam. 'TE M M (FL -
Name of person: making statement.
Personally Known OR Produced' Identification
Type of Identification
Produced
Commission
PLANS REVIEW I VEGETATION EVIEWSEA REVIEW I MANGROVE