HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 aD —a6t;?_0 Permit Number:
COUNTY
F 0 :RA 0 A
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue Fort Pierce FL 34982
Phone: (772) 462-15.53 Fax: (772) 462-1578
Building Permit Application
Commercial Residential
PERMIT TYPE: CA&n e OVfiVAC_
PROPOSED IMPROVEMENT LOCATION:
Address: 3 3 S M 1AAA N- < <W--, . 47;�-(- Pi CA-r-P , P rY`V6- .3ua R'a
Additional work to be performed under this permit- check all that apply:
Mechanical _ Gas Tank —Gas Piping. _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
� 1 �1 t
Total Sq. Ft of Construction: �. 0 /tom- Sq. Ft. of First Floor:
0 od
Cost of Construction: $ 5 b '� Utilities: _ Sewer _ Septic
_ Windows/Doors
_ Roof Pitch
Building Height:
OWNER/LESSEE:,,-
CONTRACTOR:
Name;r"13 f4_&ng_0
Name: (-• W(LOAMS
Address: i %SC Rok p ►l
Company: �{1 �ii(' �t1Acl 66
e3q
City: Sh4a P ' State: lei
Zip code: 3 5%qlf I Fax:
Phone No_ -7?Q--e28,<--S77ffq
Address: c&,J� UE Pr;pnNe Vt S-k jg I Ua
City: SSE-. Lac t?, State:IP41
Zip Code: 3CQ$3 Fax:
Phone No-73a—(0oll-70s6
E-Mail:
Fill in fee simple itle Hol r on next page ( if different
from the Owner listed above)
E-Mail
State or County License G kC 08 i 8 T % q
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.
,SUPPLEMENTAL CONSTRU7!,Ot�N LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 IMPf4VEMENTS 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 LEW*V_0R'AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF CQIMMENCFMFFJT "
Sig ture 9f"bwneflLesseeltontractor as Agent for Owner
i ature of t or/Li s er
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST , 2 c �,,
COUNTY OF Z_U C t `e,
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
thisday ofTNoUe�.n.�m 20saloby
thls�day of 000elYi`,V)eQ.,, , 20CROby
'SO` /�
Name of person making statement.
Name of person making statement.
Personally Known _,_t,�011 Produced Identification
Personally Known i//OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
ignature of Nota Public- t f Florida)
(Signature of Notary P - State of Florida )
�j A L l sl�{I G C I N S
is ion o. •°t '`POg , t3W� a
Lary Pu �c ate of Florida
G��s t�da
Commission No. l o
` e o
Commission # (;t; 956382
362
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February
i, iZ2
`� !'�, J�` � rn(,As
9
REVIEWS
PLANS
VEGEIA ilk . due
ROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIE '.-REV
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev. 21 // 19