HomeMy WebLinkAboutBuilding Permit Application-It5 tL-��-zAJ
All APPLICABLE INFtO, MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED c' c�ai
Date: '1 �2-� Permit Number: �J J -00 J 03 I
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Building Permit Appli6tio" n'
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 y
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE: Ne. COrnsouC+T7 y>I S kclk farrT.
Address: L+413 Pressler L.1ii F+- PI'ercc T3. 34010 Z-
PropertyTaxlD#: 2434-yVZ-ODP I-900"' 6 Lot No.
Site Plan Name: �Block No.
Project Name: -csend I Z In K ' �k t emc,7e,
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CONSTRUCTION 1NFORMATIQN� ��
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Additional work to be performed under this permit- check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters X Windows/Doors
x Electric Plumbing _ Sprinklers _ Generator A Roof 12 Pitch
Total Sq. Ft of Construction: 35 29 ST Sq. Ft. of First Floor: Se4 V (4 9f
Cost of Construction: $. iD 0-coo Utilities: _ Sewer k Septic Building Height: ���
OWNERf LES5EE p,CONTRACTOR.
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Name 1 o end.12_ Rna
Rosq V
me:
Address:-,J-$$ 10hnS-I"bn Si"
`Company: .
City: fir+ h1itLit
State:E1.
Address:
Zip Code: 3L4g9a Fax:
City: State:
Phone No. -7 I (r- I
' Zip`Code:'� Fax:
E-Mail: 2. -C d l ?rFgr�
. C.� M
Phone Nqo
Fill in fee simple Title Holder on next page ( if different
E-Mail
from the Owner listed above)
State-ot County License
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IT value or construction is sz5UU 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.
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INFOR
�SUsPPLEM�ENTALICONSTRUCTI O N LILAWSMAW
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DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name: FL DPCiQV1 27U11d A-
Name:
Address: 2.2-4 ti* RVC 66
Address:
City:
State:
City: 2ro GowState: F=L
Zip: aaA102, Phon 't ti 2kSdo
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"rade,to obtairi 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 orprohibit 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, 'l. do hereby agfee that l 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'YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Le a/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORID,
STATE OF FLORIDA
COUNTY OF i�—=,C�� �-P
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of 20ZO by
this day of 20_ by
Name of person making statement.
Name of person making statement.
Perso,nally.Known OR Produced Identification
r/
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Produced
(5 gnature of otary Public- 5 e of Florida)
ignature of Notary Public- State of Florida )
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Commission No. (Seal)
=�,9
mmission No. (Seal)
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REVIEW
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REVIEW
REVIEW
REVIEW
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DATE
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Rev.
LLL53