HomeMy WebLinkAboutBuilding Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: rl 1 wbaow Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:,
E PROPOSED IMPROVEMENT LOCATION: lai,,,)C - v`i -i� i* 1 - III ! 6 it
Address: f,P5 t-lc�G1r UiV f C i'viCqa "'�%L�1S,)
Property Tax ID #: 000 • 1 Lot No, 1CP + I
Site Plan Name: Block No. �^
Project Name:���
DETAILED DESCRIPTION OF WORK:
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V i &o4 de e..Y, I-) iywc -�- -Pl fjikJdulcr E tic c coll-ti u-) rf .
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New Electrical Meter Second Electrical Meter
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CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_,_,Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: - `X_>
Cost of Construction: $ 13. ctpo. co
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNERAESSEE;
CONTRACTOR;
Name
Name: f CLi Y`lE v" r'"� ►a�, ,
Address: t.Q505 LLi!xSi_.�l, npi Blvd
Company: no*—& C' _. t
City: State:T_!
Address: t S&S. Niexvtc�icv" i,V'ne,
Zip Code: S 1 Fax:
City: S f- (,,,t _cic, State: t-_1
Phone No. fl Z -�i�} ° iJ
Zip Code: 3LV�16 Z Fax: A 4
E-Mail: t -J k r rn f- (k UQ . C,,0m
Phone No '-1� 7. ` (.02,1-1P 2
Fill in fee simple Title Holder on next page (if different
E-Mail_091Ce, r@ -loco 'sl is . earn
from the Owner listed above)
State or County License CCG 13 5 12�p'
It Value of construction Is ZSUU or more, a KECOKOED Notice of commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
Date
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SUPPIXIMENTAL CONSTRUCTION tit -IN LAW 1N1 010MATION'
'DESItN0/ENGINEEft. NQt - Appli6bi�'-
Address:
City, State,
Zip:_ Phone,.,
FEE SIMPLE TITLE HOLDER: Not Applicable
—1—,,---
Address*
City-
Zip-, Phone. -
MORTGAGE COMPANY. Not ApplirabIte
Address,
I City,
lip: irarn
Addre,
City.
Phone.—
MINEMM=-
OWNER/ CONTRACTOR AFFIDWIFApplication Is hereby made to obtaift a Permst to no ItItk wfifk And fff,1A1!atke;n 4% ot"Oe
I certify that no work or installation has commenced prior to The, hwertce of a J*fm"t'
St tuc#e Gcsunty makes no representation that is grantirw a gtermit will authorize the - it tom,.tom,.to b#W' trw Ow r3ve"
wn
hich is in conWict with any applicable Hm oe Owners Assoc ion rules, bylaws Ora of
structure. Please consult with your Home Owners Aisksoclation and review your deed of any reslrocWs 14Nf h malf 4001Y
in consideration of the granting of this requested Permit, I do hereby agree that I will, in all r&Veas,, perform tnw� work
in accordance with the approved plans, the Florida Building Codes and St. Lucie Courtly Amer Ws,
The following building permit applications are exempt from undergoing a full conturreacy review, Ira" ac4WI-1
accessory structures, svArnming pools, fences, walls, signs, screen rooms and accessory uses to anolfitr Wv4euro-miai x41*
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result In paying twice for
improvements to your property. A Notice of Commencement must 6e recorded in the pubitcre-cord's of St,
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
A+k f14a' r r n ntfr%rnaw haftirp rnmrnpnrino wnrk nr rpcordine vour Notice of Cctmmer',cemerlr'
151gn4ture of Owner/ Lessee/Contractor as Agent tor owner
STATE OF FLORIDA
COUNTY OF_-*
Sworn to for affirmed) and subsc ibed before me of
Teal or
1� �da f I f4w) 2020 by
Md WS
Name of person makingState ment,
Persona :fly Known -OR Produced Identification
(Signature
Commission No -1 Notaql KWc State of Florida
Pamela
M
STATE OF FLORIDA
COUNTY OF `-
Sworn or affirmed) and subscribed before me Of P sisal Presence or Orline Notarization
i t- "day of , Ck,
bis 2020 by
L%XV1.jC.(-0l-\ (c-noe—r,.
Name of person making staternent,
Personally Known -- z10 -Produced ideirdfication
(Signature of Notary
Ppublic State of Flond,
16 Jones
My Commission GG 98547O
- LANS I VEGETATION
REVIEWS i EW REVIEW REVIEW 7TmTL1RTtr -'-&TANGRD
REVIEW REVIEW
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