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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BCE COMPLETED FOR APPLICATION TO BE'•AGGEP.TED Date: Permit, Number: ©K�3 • i�aS� 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 PERMIT TYPE: - PRO' iD5 D MP UE EN O TION: Address: 44-1}fo 'J •/htt AfA Property Tax ID #: 1#Jz1 _ 4D11= 00C)0 -,0o/ Lot No. Site Plan Name: 62tl��s 151,4 50 P&665fZ( CT Block No. 4 Project Name: . A "aL)Ay/-s%A- • DJ�GJ ANC � �n/L! L� ilz�5 I D E�� • • • CONS RUCTlO INFORMA TION: Additional work to be performed under this permit-, check all that apply: _Mechanical _ Gas Tank _ Gas Piping _Shutters ' _ Windows/Doors Electric — Plumbing _ Sprinklers _ Generator Roof Pitch Total Sq. Ft of Construction: Cost of Construction: $ lzJ <5-6E>, oa Sq. Ft. of First Floor: Utilities: _'Sewer —Septic Building Height: �WNfR/LE�SSQ . CON MRS. ITOR: Name V15�,9&77AO A2At1NlS�Zp/J ZGe-- Name: ,Qe& 4NDo eff):E3' 7VL600 Address: 2WOO A), F"4t12 Sl •• Company: Ao7A-2 gnus �?crioo Lee City: M. A-A4 i State: Zip Code: ';.'ri, 1Ts,.. ,Fax: !i Phone•No. �o /.y� - '� Address: 133(b0 &Qc W City: til/AM l Zip Code: 5.3 Phone No 7 0 - 3 V'Y — 5T , State: PZ Fax: �,?5 E-Mail:., YO=Y? q .: ' rOh.h01?125� Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail t-e-Ves IQctq C kWID, GDar-1 State or County License — If DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone:_ Not Applicable BONDING COMPANY: Name: Address: City: Zip: Phone: Not Applicable 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 NOTICE OF COMMENCEMENT." Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contract /License Holder STATE OF FLORIDA , 4 p Cil 'C STATE OF FLORIDA OF COUNTY OF�� Cam\ COUNTY The forgoing instrument was acknowledged before me The forgoing instrument was acknowledg d before me this day of �2JC,7� 201 by this �') day of 1'`�nc 9K _ 2M by �J a O y— GI c'- l \ ALX' . mkt' Name of person making statement. Name of person making statement. Personally Known OR Produced Identification V_ Personally Known OR Produced Identification Type of Ide ' ication ���vr �'�• 6 Type of Identification Produced 9 '; Produced a ure of Notary Public- State of Florida) O49 0* 4 1in Signature of Notary Publi - State of Florida Commission NoC (Seal) Commission No. LASHAHNAINGRAi1 RAHvIING 4 #GG 275060 =m • 4� EXPIRES: December 0, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VE 1R ;,,' g p,�hrTiNd��lf6bl'�c nduPGl OVE COUNTER REVIEW REVIEW REVIEW R DATE RECEIVED DATE COMPLETED Rev. 2/7/ 19