HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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 ;L
PERMIT TYPE:; c:, 6 /,c c-.s,o(t. n in —
PROPOSE Q.1 M PROVEM ENT LOCATION
Address: 4//3 SE_1q-AA_Yn C_�4 v`C-1 _/
Property Tax ID #: 00 Cv- — U�7�j - S� Lot No. 6 0,-.,
Site Plan Name: A4 M /.3 L Block No.
Project Name: ,td , dwda �; ; t i f S• CE
DETAILED DESCRIPTION OF WORK:
Yl4 f a% d`/i'PMl @
CONSTRUCTION,INFORMATION:
Additional work to be performed under this permit- check all that apply:
Mechanical _ Gas Tank _ Gas Piping_ Shutters - Windows/Doors
Electric Plumbing Sprinklers
Total Sq. Ft of Construction:.3 d
Cost of Construction: $
Generator V"` Roof '>h.'Z, Pitch
Sq. Ft. of First Floor: / 7a3
Utilities: _ Sewer- Septic Building Height: 17 10
OWNER/LESSEE:
CONTRACTOR:
Name >v�e�_. �Ct vr�:: t' A 1 UL•.
Name:
t-
Address..
city: t .s State: F� _
Address: S' rl i;
Zip Code:`—ff4 6, Fax: v` 71- 6, A 2 �
City: ._; ii e.�
State: FL
Phone No. 17 J (d:A 1A
Zip Code:'�_5_40 Fax:
Phone No IT 6"61 :-2_
✓Sjtt'�.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mail}i4_<
State or County License e13C,
from the Owner listed above)
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 CONSTRUCTION LIEN LAIN I
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
RMATION:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 andcovenantsthat 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
igKature I Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF S-}-, L.J u 'e,
The forgoing instrwentwas acknowledged before me
this 1 day of _iJe—t— , 20W by
Name of perso J�aking statement
Personally Known // OR Produced Identification
Type of Identification
Pro du ed
(Signatu f Notary Public- State of Florida )
°1PRY PuB<i
Commission No.
AR DA S ROWE
_ a °
CUlnlydSSlon # GG 104656
wr �' <y
Exi,ires May 19, 2021
9f1,nc9�64`
Bi ndcdThruBudget Nowry Sewhs
Signature
STATE OF FLORIDA
COUNTY OF -% (-A-� V -e--
The forgoing linstrujAent was acknowledged before me
this C day of iL 20 20 by
Name of persoA making statement
Personally Known VV OR Produced Identification
Type of Identification
Produced
I — I k
(Signature o otary Public- State of Florida )
�PaY PUBS RHONDA S ROWE
Commission No. • '• ° & � sion # GG 104656
k
N9rExpires May 19, 2M021
10 f�°Q\ 6ondooThruauigotNola rysewlces
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
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REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17