HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE CGwiri.ETED FOR APPLICATION TO BE ACCEPTk�w
Date:
Planning and Development Services
Building and Code Regulation Division
S Permit Number:
Building Permit Application
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE:
Commercial Residential_
PROPOSED IMPROV ` CATION:
Address: S'r e.V uC
Property Tax ID #: D 6 9 O 6n Lot No.�_
Site Plan Name: ---(T e h ccire� Ce �, C� Block No.
Project Name:
QETAILED DESCRIPTION OF,WORK:
U \IYA.
in.
03�-Flti, �
CON'5TRUCT(ON 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 I 2 Pitch
Total Sq. Ft of Construction: coori S(�tVSq. Ft. of First Floor:
Cost of Construction: $ 1aS 6 ao . a! Utilities: —Sewer XSeptic Building Height: 1
OWNER/LESSEE:
-CONTRACTOR:
Name �,� ex:�n v S �e �c
Address: 6v76,q Oi Isnvnuk4i ems •
City: 0 e )k 2State: fa—
Zip Code: Fax:
NameeI
Company: �Almm^✓3 C�d�t �L� �I/luP 24?,m.&.4-
Address:�S3Z0
City: hr. th n c h,✓ State: FL.
Phone No.
Zip Code: S3_11 1 Fax:
E-Mail: 5015 Pik/'P[C&M-Al ceiyiA
Phone No
E-Mail 22M4,Ylo/a d �&'/l.S-9, . u e_
Fill in fee simple Title Holderbn next page ( if different
State or County License elc IR J -xa a 71
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requires.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONST
LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phone.
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
Not Applicable
MORTGAGE COMPANY: .-lglot Applicable
Name:
Address:
State: City: State:
Zip: Phone:
of Applicable I BONDING COMPANY: --Not Applicable
Name:_
Address:
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 witNany 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 IMPROVEMENTS 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 o wner essee/Contractor as Agent for Owner
Signature of Contractor/License Hol er
STATE OF FLORIDA j�
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STATE OF FLOR
COUNTY OF
COUNTY OF
Nay arc tate of spricip,
VIRIMam B Layne
N Publ to f
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ay of My Commia i G 2adwO
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this / day of
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Name of pe son making stateme
N440 of person making statement.
Personally Known OR Produced Identification
Personally Known V OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
�Fev.2/7/19