HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r,,
Date: �- �� Permit Number: "�
J RECEIVED
P s
DEC 311101
Building Permit Application
Planning and Development Services Permitting Departmtant
Building and Code Regulation Division
St. Lucie County
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE:
PROP„OSED 1MPROUEMENTLOCAl
4 f t my 1
l
Address: ',9 Z A 44 m n o Gle- IC1 c !Lf f C2 q%
Property Tax ID#: - L? - Lot No.
Site Plan Name: Block No.
Project Name:
DEAILED'DESCRIPTIQN OF
A .c C k A-&<•o f OAJ
CONSTRUCTION fNFORMATION
Additional work to be performed under this permit-check all that apply:
Ymechanical _Gas Tank Gas Piping _Shutters —Windows/Doors
_Electric _Plumbing _Sprinklers _Generator --Roof Pitch
Total Sq. Ft of Construction: ' /D .S, Sq. Ft.of First Floor:
.ram
Cost of Construction:$ /Oda "- Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE CONTRACTOR
Name_ GI &rZ Q 2 J o - -�- Name: k A-1 h A-u/ --, C--i-
Address-_OTO 2 D Cr— Apt Company: MC 4 T4eft",AUr;_
City: fro�-� E� ' State: • Address: 57,cJ 4V
Zip Code: Fax: City: P SL State: L '
Phone No. Zip Code: L/ I Fax:
E-Mail: Phone No 3:?z_ -i 3 ZZ O -
Fill in fee simple Title Holder on next page(if different E-Mail PA er CZQ ►S ,) . Coy
from the Owner listed above) State or County License d
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.
....ATION
SU P;PLEMENTAL CONSTRUCTION LIEN LAW INFORM
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone 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 MRST INSPECTION. EF YOU IINTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
S' na r of Owner/Lessee ontractor as Agent for Owner Sig ature of Contractor/L cense Holder
I
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The for o'ng instrument was acknowledged before me The forgoing instru ent was acknowledged before me
thi day of 20 V by this day of / 20�j by
i
n_ G-
Name of person making6tt ent. m Name of person making ateent
Personally Known tl_ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced ZI
(Signa of No ) (Sig7si
Tn
Public State of Flori
o ROSA E.GONZALEZ
Co ssion ISSION#G 1349� I) ComOSA E.GONZALE7r alEXPIRES:July01,202 Y COMMI #GG3495055EXPIRES:July 01,2023
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
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DATE
RECEIVED
DATE
COMPLETED
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