HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 • � Permit Nui
MAR 12 2020
Building Permit Appli a ' n
Y ��l'16�ting cl-apr7.6"�CI' ent
Planning and Development Services Building and Code Regulation Division fit. LU C I C: County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE:
PROPOSED, IMPROVEMENT CO.CATION '
t
CONSTRUCTION INFORMATION:. {
Additional work to be performed under this permit —check all that apply:
_Mechanical Z( Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ ag'a i OOo Utilities: _ Sewer _ Septic
F
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE;.
CONTRACTOR•, _
Name_ - My drca Reja:l Prope..4 e _ LLc
Name:0IGff�L
Address:_ V.'f. FtAe „4e_s
CompanyLVILSO/JS i°�(-V—Eum F4N41'
City: Ve-r-a .Rp ac k State: EL
Address: /203 5Oc47-1)' R/ —f3;r-
Zip Code: 3 aq(,3 Fax:
City: F06zfF P1A0-'c0 State: FG
Phone No.
Zip Code: 3(4 / q% Fax _gC0e_ _5203
E-Mail:
Phone No —779-- "1 &?- 36N
Fill in fee simple Title Holder on next page ( if different
E-Mai[Ml�ZK<,' 6' L✓Il1Sa�%s-P COL /�'1,cG
from the Owner listed above)
State or County License'C'-i�''o �9
n vdiue ul wnsirucnon is .?Louu or more, a KtLUKULU 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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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFQRMATION
,...
DESIGNER ENGINEER:
/
Not Applicable
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MORTGAGE COMPANY: Not Applicable
Name: �P c�c�n �S.c�
,�
Name:
Address:
Address:
City: Vic,\\o'-_
Stater
City: State:
Zip: '���K Phone 2\4
.
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 YOUR.NOTICINOF COMMENCEMENT."
Signature of ner/ Lessee/Co tractor as Agent for Owner
Sigriature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
LuG/
COUNTY OF )
The for oing inst ent was acknowledged before me
The ff orgoing instru ent was acknowledged before me
this; day of 2Q:2 by
this ``a-- day of 2Q by
Name of person making statement.
Name of person making atement.
Personally Known
OR Produced Identi
atioAz
Personally Known OR Produced IdentificaM
Type of Iden ification
o m —
Type of Identification
Produced
c,3'` U0
Produced
KO N C
�3wo-70
A
�3o�r-.
o�
- gD
t of Notarylic- a e of lorida)
w m D
(Signature of Notary Pu lic- State of Florida) z'd
Commission N (Seal)
m Um
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Commission N�� 7 (Seal) "' r
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.