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HomeMy WebLinkAboutBuilding Permit Application i Ail APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I� l I Date: Permit Number: Cp 1C)3. 0q0 - - -" Building Permit Applo.cata®n Planning and Development Services i Building and Code Regulation Division i2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _ PERMITTYPE: Address: "2qt0(,,e 4pI?_0� 1��-� C��- �Si✓ �L 3 LC�t�Z, I rope rtyTax ID #: 0?- 000L f�, 7 Lot No.�_ Site Plan Name: Block No. &0 Project Name: 5 AVi JO&Yh 1.-E Gc.u1 >=��lz� fzeT C= c � f d 12m tau a —_P L-�C� 5 L-tW C�l�c"-5 �» 5 L"i� (&Act aA G-(5_ Additional work to be performed under this permit~check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric Plumbing _Sprinklers —Generator xRoof` ��- Pitch Total Sq. Ft of Construction: 44® Sq. Ft. of First Floor: Cost of Construction: $ f-7bD-"' Utilities: _Sewer _Septic Building Height: �pSE '? mg�ERI — >F- �_ Name�._ r=�'[_ K PiLx 5'?,LL" - Name: �'TEV�1J CAS�6t�j U§q Address: -7`tQ6 LP02-AC- e_1e Company: �A�r6NC�C � lZ�orW6- LLC- City: 71 S L_ State: FL_ Address: 3A )k Zip Code: 3461 5-2- Fax: City: T�k 'PICP-LE- State: L,_ Phone No. Z,©3 _S Q� $'D�o� Zip Code: 3`tc►8Z Fax: E-Mail: Phone No '-)-)Z ZI& Fill in fee simple Title Holder on next Page ( if different E-Mail +RRCOFW from the Owner listed above) State or County License r'�GDss ��16-2- 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 BOLDER: _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: Y FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT Pild YOUR PAYONG TWICE FOR IMPR EM TS ' RORERT�f. A i�!®T9CE ®F CO�P>� t?1 RECORDED AND POSTED ® �O� EFORE �@� F9R5T �i�S9�lECTaOP3. 9F YOfli E �3 O�TAaR4 FB i�CING, C®�95flJILT WITH YO NDE AN ATTOR `d BEFORE RECORDING YOUR F COMMENCE RAT.': Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF l.r: o COUNTY OF The forgoing instrument was acknowledged before me The f+ooing instrument was acknowledged before me this��day of ONG(y: 1. 20�'by this I day of rr� t b` 20y by c� Name of person making statement. \ Name of person making statemen . Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification PrNduced Produced i nature of Notary blic-State of Flo da ) gna ure o Nofa'r, :Publ 11Vdfd63dAr2& ING t MY CoijIMISSION It GG 275060 Commission No. -- 1�— Y fi #= �} Commission}Vd, a, EXPIRES:Decembegngpy-2 °r ASH yA ING12ANI-R•'H"SING F: a'Fi4:' Bonded Thru Notary Public Undervniters ON 4 GG 275060 �.,.: + ES:December 0, REVIEWS _ E QmtwooFublic ❑ r JSOR PLANS VEGETATION SEA TURTLE MANGROVE 1'.. and d LCf REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.