HomeMy WebLinkAboutBuilding permit appJR tit LL7
Date: Permit Number:
L L c L CTF, C U I !f
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
ixe3 :4 P: 2_1s r0
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
At
sa
T-roperW Tax ID Lot Wo.
Site Plan Name: Doak All e'l Block No.
Project Name:
Hew i VL701 -Mtl'e I Ifiecifical Mit-tel
I CONSTRUCTION INFORMATION:.-, "*--
Additional work to be performed under this permit— check all that apply:
Adecitanicd! Gjs7 Tank Gas Piping Shutters
Electric Plumbing Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: S .1�p 0 0 Utilities: Sewer sentic Ruilding Height-
r- - --
L 1VA04EERIL 50t-.
Name —Je.5-5 i , Cig e- n S
Address: IY320 24
City: — i--4 Aerce State:
Zip cocte.,
Phone No.
E-Mail:—
Fill in fee simple Title Holder on next page (if different
frnm tha niurpo AFtp4 4hovoP4
i J Ni T rn' fw� 4
Name: IL 0
Company: Ck 0 I" LeaGIA P �Fn 0 rs
Address: )817 J LU M I
Zip Code: 3 yJ Fax:
Phone Nocz;,;* .320_0011�&
E-Mail -P'C/(70fLC"-/' /tv t/"O.
tatp rxr rni-intv I lrpncp
if value of construction is- Z500 oT more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
3&<UPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESK R/ENGINEER: _ Not Applicable I MORTGAGE COMPANY: Not Applicab
Name: I Name:
FEE SIMPLE TITLEHOLDER. Nat Applicable
Name:
OWNER/ CONTRACTOR AFFIDVIT: Application is here
I certify that no work or installation has commenced prior the issuar
.amermit wdl
gip: Phone-.
BONDING COMPAN
Name:
04*9-w,
Not Applicable
obtain a permit to do the work and installation as indicated.
a'e4,a permit.
ri rmit_holder to.build the subiE
e�' €; e z t rnzy� resqrio C-4
In r rt deratlorr ot the graffing of tl steel perrrilt, l do hereby agree that 1 will, in al s pees,erforrntl€ewrk
in accordance with the approved s, the Florida Building Codes and St. Lucie County Amen nts.
The following building perm' pplications are exempt from undergoing a full concurrency review: ro additions,
accessory structures, sw' ming pools, fences, walls, signs, screen rooms and accessory uses to another n -residential use
A G O *Your ure to record a Notice o mt may rest in PaY1 ' fog
ttt o A_� C�e��rt re�d� i �..
b urr .and pr��d arr �� j� �t� before �� rs� inspection. i y� � r� �� obtain zb� consult
lender or ann attorney before commencingwork or recordingour Notice of Commencemen .
t 0W'f*T., Uees_�'ee, _':u.-.e .s Ager ChvrT f
STATE OF TLOKOA
COUNTY OF
�jSworn to (or affirmed) and subscribed before me of
� — Physical Presence or Online Notarization
l sl u - - -- , z a
Name of person making statement.
Personally Known OR Produced Identification
Tvpe of Identification
STATE OT TILOKMA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
d as -- day oil- - 202E !jy
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
(Signature of Notary Public- State of Florida) I (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
5"7T A r
�y x
Oc C •1 I Cc d� rs �- i c "P-
e B'e- ViLiMl Viteer ec fit; k- a _ e
CONSTRUCTION INFORMATION: -
Additional work to be performed under this permit- check all that apply:
�Mer-ftarticdi Gas Tank Gas Piping °[1Uwez s Windows. i root _
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $n ® Utilities: Sewer _ ._ Septic Building Height:_ _____,
Name Je63 ; Ca 4; .f c-n S Name: J ^, L o
Address:. V320 C,4r;,5Sati e2ol , Company: )- co- Pe
City: l W'4 Pierre State: Address: )817 sw Milli' (< ;►., /�✓
r zfP Code: B _ _ city: � rfi ,�. � v i- Stdne_:
Phone No. Zip Code: 3ylj-3 Fax:
E-Mail: Phone No ;2> .32a - 87
Fill in fee simple Title Holder on next page (if different E-Mail 9 f�nrlocG�� L/4h00• (�rh
frnm fha t1w_no_r Ur_tP_d ahnu_ol I Statp nr .i nuntu 1 in mza � c
If value of construction is 2500 or bore, a RECORDED Notice of �Cbmmencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
PPLEMENTAL CONSTRUCTIONLIEN LAW INFORMATION:
DESI R ENGINEER: Not Applicable 1
/ pp MORTGAGE COMPANY: Not Applicab
Name: Name:
l r� _
dip. Phon Zip. Phone.
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPAN _Not Applicable
Name:
Name:
Phone -
Zi
OWNER/ CONTRACTOR AFFIDVIT: Application is hereb ade obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior the issuance a permit.
St_ Lucie County makes no reoresentationthat.is;er iqg a,nermit uvillauthor' he permit -holder tobuild the 4Aiectstruoture
r. r i ip tn, � in -WA ai apilstaw H imme C ers x or, rlim ru�� vbiws v €:ovemnl i"ol � r�i i €iT-pn iibil sub ,
s r ? _ it i h Vow r . r � i -as-,�f net ww ar 6--e i .:_ re i. li wh h.i� .
In criderori the grantt €Iola nester per:riit, i do here agree tl iat 1 Will, in al spar ts,rfur the work
in accordance with the approved s, the Florida Building Codes and St. Lucie County Amen nts.
The following building per pplications are exempt from undergoing a full concurrency review: ro additions,
accessory structures, swi ming pools, fences, walls, signs, screen rooms and accessory uses to another n -residential use
WA G_0 ; Your tafture to Record a Notice of Commencement may result in Pay .. .�fo r-
�t . '.i€ii: 5 .
L td ounty, and pasted on ate jobsite before the lust inspection. ff you intend to o�in n ft consutt
lender or an attorneybefore commencingwork or recordingour Notice of Commencemen .
4 "of c4wT*q as F . w
STATE Of TILDRIDA
STATE OF-10RIDA
COUNTY OF
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
i'
this — s;r s -- — hisLUAU
i
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Tvpe of Identification
Type of Identification
i
(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
R�E/�CEIVED
TF
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