HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: rR _ d. /. �PD Permit Number:
s
Building Permit App licatiorf EB 2 7 2020
Planning and Development Services �,_.
Permitting DepEirtment
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie Co I ` r FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial sidentiaf
PERMIT TYPE: ��z)'1-r
PROPOSED
IrMPROUEMENT LOCATION:
Address: /OS Ave Y
Property Tax ID #: o?V7'�5 - ?C4- C'L7D /'-�D O - -7 Lot No. / 2
4-3
Site Plan Name: Block No. A
Project Name: (//�/ r 4 `,k7 InIfyl?A ._io LIns9 ✓!
DETrAILE01 DESCRIPTION OF WORK:
ll ✓a( o n o% z 94,Y44S ,7 ear ;P, --,o
; 10
� �c�io � �i��jU,� In< NxlS %S �ilre ��C,l✓►�CITC�[2Yh('
or
CONSTRUCTION I INFORMATION:
Additional"rktobeperformed under this permit -check all that apply:
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_Mech�anical _GassTTank _Gas Piping _Shutters _4-Vindows/Doors
_ Ie�E ctric ., Ium6ing Sprinklers _ Generator vRt%f _-_ 2 Pitch
"'7
Total Sq. Ft of Construction: ! Sq. Ft. of First Floor:
Cost of Construction: $ f/D, Do o Utilities: _Sewer tic Building Height: /O
OWNER/LESSEE:
CONTRACTOR:
Name r TC�2✓d' i
Name:
..
Address: - '
Company: �Pdrr:D ASS �n i LLB'
City: f �� Y% P'"" �'` "' ' State:
/
Add" r%i2 �d
City: State:.
Zip Code: --— Fax:
Phone No. '77;2 - y7S — 9&jIQ
Zip Code: Fax:
E-Mail:40Wonna2.11(0)op orxs-i:YIB'f-
Phone No 772,-Y-7p(3
Fill in fee sim e r e t erent
E-Mail rr < h RL� ® CG:7Ci7 •691v
Notary PUWie State of to tla
from the Ow t�l ali"' Harris �
�7 A�!
State or County License (
Af My Aa iasion GG 233873
If value of const r I Wc,tice of Commencement is required.
.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
iPs ► Notary Public Stet; of Fl;rle9
Sophia Hams
11 j( ags,W,Go 236973
a
YA
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 IMPROYEMENTS 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."
Rev:
SU PLEMENTAL C?t?NSTRU
DESIGNER/ENGINEER: _Not
Name: r a7
lON I
Applicable
FORMAT 0
MORTGAGE COMPANY:
Name:
Not Applicable
Address: ;
��
Address:
City:
Zip: Phone_ gSrl-77Z—f+'3
Stat
5
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
_5���/
Signature o Own / Le ee/ ntra r as Agent for Owner
Sig�r Lure of Contractor/ ense Holder
STATE OF FLORIDA /
STATE OF FLORIDA
COUNTY OF .SJ'• L,,r f �
COUNTY OF
The fqr ing instru, ment was acknowledges ',afore me
The fpp�oing instrument was acknowledge+ before me
this ay of��, 21� by
'7!<
thi4� day of .jlJMi.rJ,.-,C�_ 2� by