HomeMy WebLinkAboutBuilding permit application All APPLICABLE INFO MUST COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: Q
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w.___w _.__.... :. .._...__._.. __ 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:
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PROPOSED IMPROVEMENT I.00ATION' , w.as x Y at ,
Address: C/ L114oQ�
Property Tax ID#: ��11 — �' - C)0 z /—wo — 7 Lot No. a o
Site Plan Name: ry e rcL /Li c-_T m' Block No.
Project Name: / rV7 e f !R /r�10
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DTA'iLED DESCRIPTION QF WORK 3
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Additional work to be performed under this permit—check all that apply: -
_Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors � ,�.
Electric _Plumbing _Sprinklers _Generator _ oof �/2 /2 Pitch
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ // a o, Utilities: _Sewer _Septic Building Height:
am I "ie4;L Name: Car G)._1,6 a o oa s
JAddress:9 7r �5_ �7X Company:�/°gs7L6/po�dys
City: �'tNS`eti �e State: Address: 3y 2 S s`✓ 78' G
Zip Code: 3 4r`i X 7 Fax: City: &M State
Phone No. Zip Code: 3�g 9 Fax:
-Mail: Phone No 172
I in fee simple Title Holder on next page(if different E-Mail
fr the Owner listed above) State or County License_('G C
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION � `, � t,
;gin
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone 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 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 YWI§NOYKE OF COMMENC T:-
Signature of Owner/Lessee Contractor as Agent for Owner Sl natu a ntractQr/Lice se Holder
STATE OF FLOR A STATE OF FLO // N H
COUNTY OF��r�"� COUNTY OF 2` ylbee
NVQThe for oing instru ent as a nowledged before me The forgoing instrume t was acknowledge 0
�n �}this day of J!C �.++ 20�� by this 3` day of rv,7'�.y�c� ,20 w oName of person making statement. Name of person making stat ment.Personally Known �uced Identification Personally Known R Produced IType of Identification Type of IdentificationProduced RICKY CARL COCHRAN.������� •• Produced .
e „`. Notary Public—Slate of Florida
� mission#GG 172136 „...
s•,Illu .v' y Comm.Expires Apr 26,2022
h National Notary Assn.
(Signature of Notary Pu r a z (Si ature of Notary Public-State/of Florida)
Commission No. � �3� (Seal) Commission No.66 I72/3 (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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