HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 17`15-^1 p t Permit Number: 1� O� bqa3
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE: -�'d
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Building Permit Application Qua 2S TO
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Commercial_ Residential
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Address:
Property Tax ID #: o pro- tmM /� /� Lot No.
Site Plan Name:gr. L-kpE NJgM OU�lZTC/}I�T Crud 1RAnJff- ToWa Block No.
Project Name: &Ufj !j?AAlQC 7-00/e,4e
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Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Windows/Doors
A ElectricLf#S �_ Pluml1biittnlg� _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 'r-fi 'I S4 'FT. Sq. Ft. of First Floor: _ zR (0 SQ Fr. 04, to
Cost of Construction: $ (b� . n �. 00 Utilities: _ Sewer _ Septic Building Height:
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01NNER/LESSEE t x�ww �
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CONTRACTOR w t$'4
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Name OWE( c`� 4!� ( jl-,
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Name: 2£S 11%W,S6t V
Address:1)_n1 {�,C 4 C�_ _. dvX/� .
Company: /y%tM-4 461,4O061S ZMC.
City: i-pi0 go-Q- r,_ State: JE� .
Address: Si�O J Gt%OppS G Sr- ABC•
City: wmr# State: J4,94
Zip Code: Fax:
Phone No.
Zip Code: 33ffg�.3 Fax: ,S'X
E-Mail:
Phone No — Z.
Fill in fee simple Title Holder on next page ( if different
E-Mail L 494# AV • GO
State or County License___ Z84 /4
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
7
SUPPLEMENTAL -CONSTRUCTION' L•I'EN' LAW,INfORMATION:
Name:. °
Address:. - — -
City: State:.
Zip:. Phone.
FEE SIMPLE TITLE 7HOLDE_ Not Applicable
Name
Address:
City: _. . .
Zip. - on _
OWNER
MORTGAGE,COMPANYc Not Applicable
Name:
Address:_-
City:.. _ . - State:
Zip:. Phone:
Not Applicable
Name:
Address: -
City,:
Zip. y Phone:.
/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
certify that no work or -installation has commenced prior tothe-issuanceof a permit.
St. Lucie County makes no representation that is.:granting a permit will authorize the.permit holder•to build the subject structure
which is in : hfflict with any -applicable Home Owners Associatiomrules, bylaws or and covenants that may restrsubject structure
structure Please consult with yourHome.Owners Association and review your deed for any restrictions Which may apply. such
In consideration. of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building'Codes and -St. Lucie County Amendments.
The following buildingpermit applications are exerript-from undergoing afull concurrency review; room additions,
accessory -structures, swimming;pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE' OF COMMENCEMENT MUST ,BE. RECORDED 'AND
POSTED ON THE JOB SITE BEFORE, THE' FIRST INSPECTION. W YOU INTEND TO OBTAIN FINANCING;' CONSULT
WITH -YOUR LENDER OR -AN ATTORNEY' BEFORE RECORDING. YOUR NOTICE. OF.COMMEMCFMFNT_"
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..,b.—,.-1 wwll / Lessee/t�ontractorasAgen$fd'Owner
STATE -OF FLORIDA
COUNTY OF_ , 1"U0 -(
The for oing inst�um nt was acknowledge�efore me
this '.day of _ 20 / by
of person making sti
Personally'Known . OR Produced lderitification .
Type of Identificati
Commis" # GG 23M
Expires June 21, 2022
(signature of Notate
Commission No.
REVIEWS 1. FRONT
COUNTER
NDING
Signature of Contractor/License Holder
STATE OF.FLORIDA +
COUNTY OF._. S C
The forgoing instrument as acknowledged before me
this /S .day of J([ 20_ by
Name of person making'statement; -
Personally Known . ✓ OR Produced Identification .
Type of Identification -- - -
CKIN HUM-'
C°mMssim0GG23 W
Expires June 27, 2022
of Notary Pu
(Seal) Commission No. (Seal)
NING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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