HomeMy WebLinkAboutBuilding Permit Application �i.
II APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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I Building Permit Application
Plaguing and Development Services
Building and Code Regulation Division
2300.Virginia Avenue,Fort Pierce FL 34982
Phdrie: (772)462.1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
OEM
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Property Tax ID#: -1414 --CoOa•= jy 5 Lot No.
Site F'fan Marne: Q1,LYlloC LendI !dock No
Project Name: Da'(`1'L.(1}
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Additiona(work to be performed under this-permit-check all that apply: /
Mechanical ,Gas Tank _Gas Piping _Shutters II Windows/Dogrs
Electric —Plumbing Sprinklers Generator Roof P.tch
Tot,Gi Sq. F`ci Cnrs�W'Lion: _ u _ Sq. Ft. of First Floor:
Cost of Construction: S � (%Q��• utilities: Sewer Septic Building Height:
Name
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a°cldress: f3Ty. Company;M kk EATLkpc LU,o,'TLeA�� F�eryfSlrh��«r ;
�11,Y: per._ State: Address: (M 6 I`9f11lLhQ�, IL p�. best"
Zip Code: (�_- Fax: City: Ilft" l rb�•k- troG�� State: f
Pone No.. Zip Code: 3?.q'b j Fax: 3a4
l` ail.-�(c at G� ?��5•�' IYL_ l Phone No -7~7'd-337-4j 7U )I.
'dill in fee simple Title Holder on next page(if different E-Mail g I,(.
froth the Owner listed above) State or County License__ qi 7 i
tf i'r ue of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If Vague of HVAC is$7,500 or more,a RECORDED!Notice of Commencement is required.
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!]£SI1111/iENGIIVIIII2: _ Not Applicable MORTGAGE COMPANY: _Not Applicable
Nai1e:: Name:
Address: Address:
City: State: City: State, _
Zip Phone-_._...-•--..__...Phone ----- Zip: .------ Phone: �II
FEF'$IMPLIE TITLE' HOLDER: —_Not Applicable BONDING COMPANY: _ _Not Applicable
Name: �- Name;.
Addr're.;s: Address!
City:
Phone: - - ----- - Zip:_ Phone:
WNER/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.
t. ui iF_t,0,Xtv rY:akc s n:�;capresentation that is granting a permit wiil aui horize the permit holder to build the subject structure
I'iicli;is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
trucf`ure Please cony;'It with your Home Owners Association and review your deed for any restrictions which may appiy.,
n cor sideratiorr of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
n accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
f he fgllowing building permit applications are exempt from undergoing a full concurrency review: room additions,
ec7s'�jr'struci.urE S, sw'.i'rltning pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
`WAA�WIii G -1-0 OWNEW YOUR FAILURE TO RECORD A NOTICE Of COMMENCEMENT MAY RESENT IN YOUR BAYING
'TWI,(:E FOR [IMPROVEMENTS TO YOUR PROPERTY. A NOTgC'r OF COMMENCEMENT MUST BE RECORDIE-13 AND
E!0!,51MG ON TIM jOB SITI= BEFORE THE FIRST INSPECTRON. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
I WIT[I TOLL R LENDER OR AN ATI.ORNE.Y BEFORE RECORDING YOUR NOTICE OF COMIMtENCEMENT."
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Sign Lure of Owner/Lessee/Contractor as Agent for Owner 5igna Lire of contraKr/License Flolder
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6i4L;-E �3F iFLCri ° STATL OF FLO A 1
COUNTY Oi �:i�Ell�f eY OF
The°i:or;oirg lnst,'wiierit was ac rlowleo oefore me bill? i 1' Inv,Instru nt was acknowledgeci before me. 1
this ay of Z� by this day of 2011 by
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Narr e of person rralciing statement. Name of person making statement.
PP.rSt1n,sly Knr,wr• „ OR Produced Identification � Personally Known OR Produced Identification;--__
{ i d... it>> Type of identification
Prc1ci' r.r Pr-odur..ed._-.-_..
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(Sisatrire of ctary Pu o-State of Florida ; { nature of try Public-State of Florida )
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Con''ir�lis.sion No Sea ) O iSSion NIo. @
Notary Public State of Florida s�aMs� 4wr Aota sh By M Public
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I ReVIEWS FROND' I P S VEGETATION SEA
COUNTER REVIEW RE E W REVIEW R£ E R VIEW
DATE -�
RECr EiVED _
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