HomeMy WebLinkAboutBuilding.permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Z ZC? Permit Number:
j
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:plac�ynerv�' L104L4W Ruju-
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID #: /W/ vi al -O�Zc- -00 -8 Lot No.
Site Plan Name: �Gtt1�G'C� k- Block No. 1,30
Project Name:
DETAILED DESCRIPTION OF WORK: I
CONSTRUCTION INFORMATION:��A
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:
Cost of Construction:
Sq. Ft. of First Floor:
Htilitiec- _ Cewar _ Ceptir Ruilding Naight-
OWNER%LESSEE:
CONTRACTOR:
Name DOCK j
e--,
• : ^ a LK
,y:
Address:) �� c�`I �'1 !v 1LOTZ4f-
Address: c�.�J�
City: R ieA-
Zip Code: 377`i95)
Phone No. I-3o-�Z�
state:F(-•
Fax:
So-_<93
City: -fe(A5V I,Pi-tif State:f L--
Zip Code: 3gq�oZ Fax:
Phone No��O�-�3�-
E-Mail: '6 cLca 'QIfflek
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail D iirWt�l1 ��C)t/Vl /l
State or County License
If value of construction is 5Z500 or more, a RECORDED Notice of Commencement is requirea.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNfR/ENGINEER: _Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: Name: —
Address: City Address:
State: City
Zip:. Phone Zip. Phone:
State:
FEE SIMPLE TITLE HOLDER: ____ Nat Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City:
Zip: Phone` City.
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 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 1 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 concurreil 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the�jobsite before the first inspection. If you tend to obtain financing, consult
wittylender or an attorney bef a commencing work or recordinvAint�r l i�o rsf
r— Illy
as Agent for Owner
STATE OF FLORIDA
COUNTY OF �! Lk U it
Sw_ opn to (or affirmed) and subscribed before me of
V P(lysicai Pres ce or Online Notarization
this ��$$ day of 2020 by
Name of person making statement.
Personally Known v""' OR Produced identification
Type of Identification
Produced
of Notary
Commission No
OIANE COLE
Nota b1ljj'ff State of Florida
Cidn # GG 961089
My Comm. Expires Mar 14, 2024
STATE OF FLORIDA
COUNTY OF S1
Sworn to (or affirmed) and subscribed before me of
li Physical Pres nce or Online Notarization
this day of ' 2020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Prodpced
Signature of Notary Public- State of F` DIANE COL
Notary public - Stat+
Commission No. j Commission # GG
MY Comm. Expires M
Bonded through National f
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
DATE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
-
RECEIVED
DATE
2024
Assn.