HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST B E CU M P L L U FU K AV FLI LA U 1vIv i u nt: rj izv
Date: ._
Nanning and Development Services
Permit Number:
Building Permit Application
Building and Code Regulation Division Commercial Resiclentia
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1-578
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Additional work to be performed uncfe
Mechanical Gas I ank
Electric
Total Sq. Ft of
Cost of Constr
Name
Add ress:__,j
City:
Zip Code:
Phone No..
E - P0 a'l 1: ✓�
P I "r-nnina
th'is permit—
Gas Pi p'j'n
Sprinklers
check all that apply:
Shutters
Generator
Windows/Doors
Roof
Pond
Pitch
Construction: Sq. F.
of Rrst FIDor:
U ctio - *es: Sewer Septic He*lght:
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M.,
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C�
) C'. )OAS,
State:
Fax:
��GIF-ti Yl,
� Fill in fee simple Title holder on nex
from the Owner listed above)
page *if different
Name:
Com an\
Address:
City: �r ;t�
Zip Code:
Phone No
E-Ma'il
State or
r I
-Vk 002 -A
7 1 1 -") - jWS1. ,
„y State: ill
Fax:
tense
Ns�
if value of constriction is 2SOO or mare, a RECORDED Notice of Commencement is required. '
if value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
FRONT
OWNER/ CONTRACTOR AFFIDVIT
St. Lucie Coun
which is in conlyl
Application is hereby made to obtain a permit to do the work and installation as is
certify that no work or installation has commenced prior to the issuance of a permit.
makes no representation that is granting a perm it will authorize the permit holder t
40
o build the subject structure
ICL w1in aRy eppllCable Home Owners Association nilac hvinwrnrnn rnlupnnnte, that may ractrirt or ornhihit ouch
1
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In considerati
ir-f accordance
on of the granting of this requested permit, I do hereby agree that I will, in all respects,
dp
with the approved plans, the Florida Building Codes and St. Lucie County Amendments,.
The following building perm
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 ot Commencement may result in aav111 ine twice for
improvements to your property., A Notice of Commencement mu
Lucie County and posted on the jobsite before the first inspection
with lender or an attorney before co enc4inR work or recordin2
it
Holder
st be recorded in the public records of St..
. if you intend to obtain financing, consult
your Notice of Commencement_
Signat6re of Owner/ Lessee/Contractor as Agent for Owner � Signature of Contra
STATE OF FLOFj,IU�A C-l
c
COUNTY OF
Stto (or affirmed) and subscribed before me of
V Physical Presence o Online Notarization
this2j\ day of 201A by
Name of person making statement.
Personalty Known OR Produced Identification
Type of Ide ic In
Produced
(Signature o otary Public-
G(2 S
Commission No.
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6/20
COUNTER
Ix -%- 1q, X
AWF
ry 4 WT77
,, MONIQUE M. CARLONI Gm�
y Public, State of Floridill,
Commission# GG 269499
1AN,r,,,.,omrn. expires Dec. 10, 202
ZONING SUPERVISOR
REVIEW REVIEW
ctor/
IF
License
f .
STATE OF FLO�QA ' ^
COUNTY OF,�'
"
Swoq� to (or affirmed) and
� Physical Presence or
thTil I day o
k
V
subscribed before me of
Online Notarization
1 , 20
by
Name of person making statement.
Personally Known OR Produced Identification
Type of Iden 'ficatov
Produced �- ,.
(sMii
ignature of Notary Pub)-1 - � f oricMq NICUE M. CARLONI
I � c: Nota
A lol State of Florida
�mmission No.ion� GG 269499
M y ��ifri!1, zpires Dec. 10, 2022
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVI EW
perform the work