HomeMy WebLinkAboutBuilding permit application All APPLICABLE INFO MUST COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: , ^/�� Permit Number:
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:
Address: q tTt( ralMe a 1-)l' F�, Ilepe e t FL Y4J 4 8 2
Property Tax ID#:341OZ -60(0 _000r-060 - '6 Lot No.o7`J-fS10
Site Plan Name: rndt0.,1 4,ye-r C G`f-aJ es Block No.
Project Name: (n 1?,e iC��v�rQ
vr�Q
edr �' -
Additional work to be performed under this permit—check all that apply:
.'//Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors
1ectric Plumbing —Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: ice, I, G-75 5Q F7 Sq. Ft. of First Floor:Ie9.
Cost of Construction:Y �� 0ey. DC) Utilities: —Sewer X Septic Building Height:
mw
Name / e- 17/ 171e& NameaoO XYA 'P Q2mc�rP 'r
Address: 13CJ /�GiGJ &YG �/ Company�2rnmYe f mSfirCi h'r A U
City: Ar/- a .ZUCl e- State: �L Address: SOU SF— \-o&&n -ezt- U
Zip Code: 2gC1 6P Fax: City: -5AA4 k State: rt-
Phone No.76cJ--l87-6 Y:� 3 Zip Code:34g97 Fax:7'7a-aaO-Oaa7
E-Mail:�'l7 S'i'YI/,('P Jn7Ce7, GG m Phone No -1 -73k- Q P o-oocoS
Fill in fee simple Title Holder on next page(if different E-Mail���vrio��ern�o��st�nn�u( ia��,COm
from the Owner listed above) State or County License CBS
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.
DESIGNER/ENGINEER: ^Not Applicable MORTGAGE COMPANY: Not Applicable
Name: I� i • r Name: 0 Address: 10 �fe a Address:
City: C &-y- i0 Stater_ City: State:
Zip: ;5, l& -5 Phone A -3 eS l g -yJ a ?_J Zip: Phone:
FEE SIMPLE TITLE HOLDER: k Not Applicable BONDING COMPANY: Not Applicable
Name: ►J I4=1 Name: NVI
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 �H YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTI E OF COMMENT ENT MUST B 'RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTIO . IF YOU NTEND TO OBTAIN FIN CING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDIN OUR N TI CO MENCEMEN "
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Signature of Owner/Lessee) ontractor as Agent for Owner Sig ature of Co ractor is se Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF V024 t;,r\ COUNTY OF �YIGL�✓)
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this dayof: Y2w)oe�r 20a0 by this ,T. day of `�f�fCrnbo_V 20 by Name of person making statement. Name of person making statement.
Personally Known t`�,>�& OR Produced Identification Personally Known nX OR Produced Identification
Type of Identification Type of Identification
Produced Produced
�J 07
(Signature of Notary Public-St of Florida) Si nature of Notary Public- a e of Florida
VERONICAL TAYL yrr„;'•• . VERONICAL.TAYL R
Commission No. `X! eal) Sion No. = ' ()COMMISSION#GG 2 77
MY COMMISSION#GG 2 ::• ;*:
EXPIRES:June 4,2 3 EXPIRES:dune 4, 2
REVIEWS FRONT LAMS VEGETATION S LE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19
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