HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Date:
S)�U' IBC iGIl�
0
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
F PERMIT APPLICATION FOR: Pef--1cr I -nsm i i n+ I on
PROPOSED IMPROVEMENT LOCATION:
Address:
_ _ — — Lot No.�,
Property Tax ID #:
vl d �1 x Block No. _
Site Plan Name: �JU
Project Name:
DETAILED DESCRIPTION OF WORK:
�C)a(0 I 1►n a 153'
. it -A—
M
New Electrical Meter Second Electrical Meter.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical —Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond
_ Electric _ Plumbing _ Sprinklers _ Generator — Roof
Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
r'nct of C.nnstruction: S (�1-300—• 00 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name l
Name:
Company:
Address: 0occc
City: P State.
Address: 1 Y
City: State:
CFax: �"
Zip ode:
Phone No. '—'
Zip Code: Fax:
Q
E-Mail: r
Pi eN
_
E-Mai `
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License
oa
if value of construction is z5uu or mure, d Rr-..WnL� •���� �• __...__._ __ _ _ _, _
if value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
EMENTAL CONSTRUCTION LIEN LAW INFORMATION:
VDESIGN—ER/ENGINEER:
ress:
Zip: Phone
Not Applicable
RTGAGE COMPANY:
me:
_Not Applicable
FAd
ress:City:State:
y:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
— Not Applicable
BONDING COMPANY:
Name:
Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
_ J
i. ,nA ;—t.11ntinn ac inriirated_
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby mace io ootain d NC11111L <V �„� ••� - - - - -
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 paying twice for
improvements to your property; A Notice of Commencement must be recorded in the public records of St.
1 "rim rni inty anri nnSted on the iobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing wor,K or r
Signature of Owner/ Lessee/Contracto Agent for Owner Signature of Contractor/License
STATE OF FLORIDA STATE OF FLO IDA
COUNTY OF II.,IC i t COUNTY OF�SJ , I 14AC
SW rn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this'IW day of 2020 by
401irvn W — —
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produc —
(Signature of Notary Public- State of Florida )
SwI5rn to (or affirmed) and subscribed before me of
P�hj�sical Presence or Online Notarization
this aP day of 2020 by
—
Name of person making statement.
Personally Known J OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No. GC�9yl.'1�.3 ("YPI
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4* *= Carnmiss on it GG 966763
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?ic^ t 76763
'!poll„��� March OB. 2024
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REVIEWS FRONT ZONINGTATIO
REVIEW REVIEW
REVIEW REVIEW
I'EW
COUNTER REVIEW
REVIEW
DATE
RICHY GOMES
JR.
RECEIVED
u ic- tate
Florida
DATE
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ommission # GG
66763
COMPLETED
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My COMM
March 08, 2024
Rev.