HomeMy WebLinkAboutpermit app - BaroneAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: "Z-(:� - Za
Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 452-1578
PERMIT TYPE:c�o�
PROPOSED IMPROVEMENT LOCATION:
Address:
I
Building Permit Application
Commercial Residential — #�_
Property Tax ID #: 3 3 fit{ 600 C'X� - 000 0
Site Plan Name:
Project Name: r1(:-- V-&A6',
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
Mechanical _ Gas Tank — Gas Piping — Shutters
— Electric — Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ _ ] > q, C-)
OWNER/LESSEE:
Generator
Sq. Ft. of First Floor:
Lot No. zJ
Block No.
Windows/Doors
Roof Pitch
Utilities: —Sewer —Septic Building Height:
Name e+e-t'- -P `N C-e-
Address: ?xktt
City: Qo r i cs Stater
Zip Code: 34 $ Fax:
Phone No. 2_3 `7 - LY 73
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACt
Name: 7- �.
Company: C_s?--
Address:3Z-11 5C �t7w+,'r►.c.� �j-e��
City: S�c�t.l� Stater
Zip Code: ��q'� _ Fax:
Phone N071 L' I'i 1 Z-
E-Mail 11\, co d C-f, bo i ( C-,-) P''
State or County License 66L Z .3 $b 3.
69.41
.--- .-• .. . .. ,. --- W. -%'I c, a n«vnurV FMVULL' uY LummencemenI is requires.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER;
Name: at Applicable MORTGAGE COMPANY: Not Applicable
Name: Address: Name:
Address:
City: State: City:
Zip: phone State:
Zip: phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name;
Name:
Address: Address:
City: City:
Zip: phone: 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 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
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROYEMENTS 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
_.��
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORI A STATE OF FLORIDA
COUNTY OF �,)r� COUNTY OF ]
The far .going instru ent was acknowledged before me The forgoing instru_ ent was acknowledged before me
this � day of v 20 2 Eby thisi_ day of l 20 Zi? by
Name of person making statement. Name of person making statement.
Personally Known OR Produced identification Personally Known � OR Produced Identification
Type of Identification Type of Identification
Produced Produced
jgnature of Notary
30g IiBADINI
nature of Notary Pu ca' 274212
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Commission No. MY ��,� #GG274212
�November25 2D22
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Commission No. .•og• Bonded P�cUtdents
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PLANS VEGETATION SEATURTLE MANGROVE
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