HomeMy WebLinkAboutBuilding Permit Application All APPLIC BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 a Permit Number:
RECEIVED
.. Building Permit Application �0nP 1 2 1021
�ermittinn I>`partment
Planning and Development Services Lq-
zte County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE: I�G��rG�J
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Address: ��`� ._. � /L ��� ��dL� /✓ cyr.,?.`.��. .3 �j
Property Tax ID#: //� �o� �� �� �� � Lot No.
Site Plan Name: ��t Gr' ��/ Z� V^,; Block No.
Project Name:
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Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
ctric —Plumbing —Sprinklers —Generator —Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ .5(
Utilities: _Sewer _Septic Building Height:
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Name 4 C•_e IV,71 /h T Name: Gera 4 ;Tb$ /Q h
Address:
++ C4M -/ G/2 Company: �✓®/✓ e , .
City: /�2�Z- ;e crr......-. ... "State: R4 Address: t
Zip Code.: ,J�f�e-( Fax: City: �Ti2 -_u.i 'State:_&rs
Phone No. e E{ 7 - -7 Zip
E-Mail: - 'S PhoneNo 7702- 3o2Oz_.
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Fill in fee simple Title Holder on next page if different E-Mails"�--"�"'"-"-`
from the Owner listed above) State or County License
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.
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _.Not Applicable
Name: Name:
Address: Address: _
City: State: City: State:
Zip: . Phone Zip: ne:
FEE SIMPLE TITLE HOLDER: No plicable 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.pules, 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 1 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 PAVING
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 F COMMENCEMENT."
Signatur of n /Lessee/Contractor as Agent for Owner Sign at s older
STATE OF FLORIDA 1 1 STATE OF FLORIDA
COUNTY OF � JJ/ h�UL� COUNTY OF
The for oing instrument`f`�as acknowledged before me The for oing instrument was acknowledged before me
this a day of N6fvk ,20� by this X day of �4441 201, by
Name of person making statement. Name of person making statement.
Personally Known L/O/R Produced Identification Personally Known !/ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-S ate o iorida ) (Signature of Notary Public-Sta e o lorida )
Commission Commissi
MICHELINE FLORIAN A 1 1,1
�0 4,Notar Public-State of Florida _�° _Notary Public-State of Florida
Commission# oar -
REVIEWS ' ,� Ex r '.,�orc�°;$ My C mmission Expire
„ N Dee F"1q, 2024 VISOR PLANS 6L°1'ATIONDe �$I�eFWRT21@.2a NGROVE
IEW REVIEW EVIEW
DATE __
RECEIVED
DATE
COMPLETED
ev.
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