HomeMy WebLinkAboutBuilding permit application r ,
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED `"
Date: r - Permit Number:20 Q -1 -- O `✓7
OUNTY
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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:
3 .,. � ... � �. 2� ��A ��"y$� �d`a .1. �•'�'' � ,�`� � ��'$a �ak 3 Z �� �.�: iH � � ^�
Address:
Property Tax ID#: Lot No. 2-ey
Site Plan Name:--7J-eA.►/ r'a lI°iMfte/ Block No._4
Project Name:�E,4/✓ e�/ems✓
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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 I (I Pitch
,�
Total Sq.Ft of Construction: 7(� Sq. Ft.of First Floor: 1795
Cost of Construction:$ 2Z 66> o a' Utilities: _Sewer _Septic Building Height:'
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,.,•..� _,;y. Kf*Y-','a''�*.^u,� .r£ ' b, ' 5�57
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Name Name: a Io y-r ll
Address: tic Company: --S-/a-l' a/. X off- Cynr�
City: State:_ Address:,Jf?S
Zip Code: 35/9 X Z Fax: City: 61,1 State: �-
Phone No. Zip Code: 35'95'0, Fax:
E-Mail: Phone No '772__ Zbo-S'75'�
Fill in fee simple Title Holder on next page(if different E-Mail _0Pc_Lir/,/�s�^ap-��,..4 �' bc�i►-,/,�,,�, 'yi
from the Owner listed above) State or County License J09C " G '39o7
if value of construction is$2500 or more,a RECORDED Notice of Commencement;' required:
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is req;_fired. �(1
41
_.a`;a �r,..w a ' ., r_.:ass,'" ,. , =�,, ,. a,�e§ ......:,. ...•,� >,. , e, ,:r u 4NSTR SUPPLMN L T W0 r; FX
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 Y U INTEND TO OBTAIN_.FINANaNC, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING R QNCEO COMM ENT:'
Signature of Owner/Lessee/Contractor as Agent for Owner gnat f Contractor/Lice se Holder
STATE OF FLORIDA STATE OF FLORID /
COUNTY OFF COUNTY OF
• •1
The for oing instrumen was acknowledged before me The forgoing instrumeryt was�cknowledged before
this Y day of -.T a ,20 2a by this day ofsev G- ,20�a by ®�
Vila
Name of person making statement. Name of person making statc1ment.
Personally Known R roduced Identification Personally Known OR Produced Identific2,
is s
Type of Identification Type of Identification j
.•••�NtY,y
Produced s�� °e:: RICK'rCAR�COCHRAN Produced
State of Florida +r"°
v,u�m •:,, Co lssinn q GG 172136? 1;'," omm.Ex ' Apr 26,2022
ruuyb Naliona
(Signature of Notary Public-State of Florida nature of Notary Public-S t F
RICKY CARL COCHRAN
Commission No. -66-/7Z/3 (Seal) Commission No. NotaryPubtise eofFlor+da
:,i _ Commission 1 In136 1
6S /72/3.( + li �vY$ My Comm.Expires Apr 26,2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETAT E URTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.2/7119
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