HomeMy WebLinkAboutBuilding Permit ApplicationA
All APPLICABLE INFO MUST BE CON.;,._. ED FOR APPLICATION TO BE ACCEPTED -
Date: `o' Z�' �� (� Permit Number:
��7 bERECEIVEDBuilding Permit ApplicationPlanning and Development Services Building and Code Regulation Division itting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential _
PERMITTYPE: SF7
Address
Property Tax ID #: J,_�J\ - (n ( _00 1_)-0rb - 5^ Lot No. ._
Site Plan Name: (o C lr1�cC�tJ Block No.
Project Name:
'DE.TAILED-DESCRIPTION OF WORK:
CONSTRUCTION' INFORMATION:
Additional work to be performed under this permit - check all that apply:
Mechanical _Gas Tank _Gas Piping 4Shutters ,Windows/Doors
�(flectric PI ing 0_Sp Alers _Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: Ym
Cost of Construct ion:$ 00 Utilities: _Sewer Septic Building Height: �17r
OWNER/LESSEE:
CONTRACTOR:
Name l_�)
Name: lsJo� S'
Company: IsJJ � LLC.
Address:33C)b 1,�f3� • Se. 16(
City: C-��S-Q State:_
Zip Code: of-7LA(n �°et:3���o�$a.-3cc)(o
Phone No. 1`1a'L(5_S liLi7J
Address:33o0 �cso�clrc\-_S'te.101
City: State:l� -
Zip Code: 0)4(C)g�-
Phone No 7%a-4\S3- 4f I Lt.3
E-Mail:tymrce
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
er
State or County License \ SS I
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 19 required.
ENTAL CONSTRU&rI kLIEN LAW
ENGINEER: K Not Applicable
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: Z Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: ?C_ Not Applicable
BONDING COMPANY:
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone
�CNot 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 Count makes no representation that is granting a permit will authorize thepermitholder to build the subject structure
which Is in con lict with any applicable. Home Owners Association rules, bylaws or an 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
o
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work orrecording vour Notice of Commencement. n
S nature o wne / Lessee/Contractor as Agent for Owner
Signature of Co Patton icense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF S�-L�cL2
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this S-.clay of 204 by
this �day of 20-aby
Name of person making statement.
Name of person making statement.
JI.
Personally Known XOR Produced Identification
END'ONOFRIO
Personally Known °I�#Od END'O OFRIU37558
Type of Identification
Type of Identification I €. •'- I�NS,arMywbrxo 0�
Produced
Produced '. e 1em
l,
4,1
\ C
v�
(Signature of Notary Public- State of o
e of Notary Public -State of Flo 'd )
Q ? '••., I(AREN D'ONO
Commission No.c��TS�y "'.•i MYCOMMISSION#
r :KARD'ONOF
jis n No.�"f S':';;x'�"'frC�I'EXPIRES:August2
76d
:"RAY COMMISSION#G
mdters I`;'; EXPIRES: August 5,
ondedTWUN-hUYPubl
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEAT' RTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
�DI31Il
DATE
COMPLETED
ev. 9/26/18