HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE.COMPLETED FOR APPLICATION TO BE ACCEPTED v
Date: 5� 2-1 Permit Number: �� V ��
ZOZ1
Building Permit Application PQrm;tt;ry MAR ®`9
Planning Stuilding and Code Regulation Division CucP cont
B ent
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential Vz
PERMITTYPE: EW
��
Address: 5213 �''c1 nf) 30'-SVe
Property Tax ID#: zO� (Q 0 Z 00915 00 !1 Lot No.
Site Plan Name: Block No.
Project Name:
gf
�7 f
L5�1 0 6
k-.,wr"]Us9
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 Constructions: Sq. Ft. of First Floor:6 Cost of Construction: $ .'10 <0 Utilities: —Sewer —Septic Building Height:
4Y `fT r -�- '� �• £ . rz .<=_t
110
.xfk rr__ , •v.-5� 'i: 4 'cam'e� 'z-` -s _.3'-irr,�:�' r.. sirtF..d r���i• w:.4 .� -d� _ s
Name TUk- Name: D wc,_. ityk Z
Address: Company: ,C n2��i11f I`J:gym `tG
City: State: : Address`"3_' `1 �/Ci\c� �I��tliL
Zip Code:, �fal�jC Fax: City: - : p��'��-e, State: FL
Phone No. CLL40��t2 2 �:::, -.:: '.,,..;', :Zip,Code-. J Fax:
E-Mail: Phone No �'1�27 �� �' Li-i-7Y
Fill in fee simple Title Holder on next page( if different
from the Owner listed above) State or County License GGe (S 1 c-F 5 2S
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.
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 FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YQJURIC NDERPR AN A NEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signatu=(of ne Les e/Contractor as Agent for Owner Signature of Contractor/License Holder
STATERIDA STATE OF FLORIDA
COUNTY OF 1 �- C L U C I e, COUNTY OF
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of /1 20,7,1 by this day of 20_ by
A-Al tie G.i l�,
Name of person makii g sstatement. Name of person making statement.
Personally Known 50 OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida )
vr�•., ASHLYNN SNVANA HAMM
Commission No. ( �r��l Notary Public COMA6n sion No. (Seal)
f �° .; Commission#HH 038161
M Comm.Wir-A g 31,2024
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.