HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: D sp nq apao Permit Number:
a
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Building Permit Application
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
PERMIT TYPE: A CaanG Out H V fit
PROPOSED IMPROVEMEN LOCATION:
Address: N C 1'1 ` 3 3
Property Tax ID#: 3y1�- 30-Oa3c-A-(�Oo--2 Lot No.
Site Plan Name: &e ffif K - U h • -r Y Block No. _
Project Name: WA l t) f LLI AMS OfREI 1, 00C C
DETAILED DESCRII TION OF WORK:
Q.VYI( W_ P_L,(S_\(\u p_40 i,A&I) A+ A- A tP' A rr� . ��C-(n � � h�0 � el
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
Mechanical — Gas Tank —Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction:
oO
Cost of Construction: $ p �T7_
Sq. Ft. of First Floor: _
Utilities: _ Sewer _ Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name W,+DC 60Il-LI NI S
Address:_ F /o-L3 A Ca' �p/2n/Ia 4of4o 2.
Name: �:IWI S L. 1A)A\1.akL
Company: CCU LCr—.
City: Aiel- !4, L Ln State:,
Zip Code: 3 Y'% P3 Fax:
Phone No; a2- -
Address:,US k)P. Pf -� a &J RIJ
City: S-�. L)c iQ, State: P --
Zip Code: 34"M Fax:
Phone No -7a -/a/- % �-LO
E-Mail: GcJ a2 004
Fill in fee simple Title Holder on ext page (if different
from the Owner listed above)
E-MailuCc�/�z� c"t p6A
State or County License C-AC /8/3 977
a value or construction is :>zbuu or more, a KtGURDED 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 MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
_ Not Applicable
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
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
IF,
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPRbYEMENTS 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 LE N ER OR AN ATTORNEY BEFORE RECORDING YOUR "TICE OF COMMENgMENT "
er/
STOF FLORID
COUNTY OF .� Z.,__",e�
for Owner 1,3i`gn Aure of
The forgoing instrument was ackn wledged before me
this day of _ 2oc2o by
b
Name of person m1.7140M
ment.,ALICIAg Pi,:tary Public-Stato of Florid
-
Personally Known per; CG �58862
Type of ldentifical
Februar;, Q°, 2024
'Pcl�c•.c� ���I�s
(Signature of Notary Pub ic- State of Florida )
Commission No. GG (Seal)
'STATE OF FLORIDA
COUNTY OF `:�3 r / .,)C r
The for oing instru ent was acknowledged before me
this day of 20a_0 by
Name of person makings e \C,\�' stste °ig'b31
Personally Known o� f jaiN
Type of Identiflcati
Produced =
Akcta.
(Signature of Notary Public-Sta*feof Florida )
Commission No. 36S a (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
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REVIEW
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DATE
RECEIVED
DATE
COMPLETED
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