HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETE'; ` ' IR APPLICATION TO BE ACCEPTED I
Permit Number: - A a- a
Date: �a��d�,_�
RECEIVED
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DEC 1 0 ?Qlg
BUilding Permit APPlicatio
ST, Lucie County, Permitting
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
PERMITTYPE: Oa
PROPOSED IMPROVEMENT LOCATION:
Address: ).31c; CA C u2 L'
Property TaxlD#: C/ —�o.� �" b0 �� 0 L� Lot kN
Site Plan Name: % IoYAN Block No.
'I
L ��i
Project Name:
DETAILED DESCRIPTION OF WORK:
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vvt er e JC Dec h
-CONSTRUCTION INFORMATION:`
Additional work to be performed under this permit —check all that apply:
_Gas Tank _Gas Piping _Shutters —Windows/Doors
_Mechanical
_ Electric _ Plumbing _ Sprinklers _ Generator —Roof Pitch
Total Sq. Ft of Construction: (9C6-2- Sq: Ft. of First Floor:
Cost of Construction: $ 3 % "Q Utilities: XSewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name L PS rn N
Name:
Company: oo S
Address: IV310 (N;)ofe,4p (?n,i-P
Address: IffikV
City: / J- ?'ewe State:/
Fax:
Zip Code: 3 �
Phone No. 23�7— 2-22- Y2L& s
City: V CIb PA C h State: /-
Zip Code: 3Z9b �7 Fax:7 )2-770- 5-56 )
Phone No 772 OM-7- 3 aG -7
E-Mail:
E-Mail
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License L'PL I if 20
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
Name: AABV
MORTGAGE COMPANY: _ Not Applicable
Name:
Address
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 ppermit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Assocation 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
as Agent for Owner
COUNTY
STATEOFORIDA { h / (%J� STATE OF FLORIDA %
_L rl _f/ COUNTY OF tid J
The forgoing instrum t was acknowledgedbefore me
this J day of I rL 20LZ by
�5J., WbllGeJ
Name of person making; ement.
Personally Known V/ OR Produced Identification
Type of Identification
CAREN B. MILLS
Com
The forgoing instrument was acknowledged before me
this 10 day of ()ec 20 /5 by
8A ci;L )-/,/lf
Name of perstfin making ement.
Personally Known OR Produced Identification
Type of Identification
Produced
• A
(Signature of
;a CAREN B. MILLS
Commission 'i ems MyCOMMISSIONA I$77
•'+'teirie�}+ S:SeptOmber4,2023
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