HomeMy WebLinkAboutBuilding Permit Application i
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater �g "� Permit Number:
�j. RECEIVED i
Building permit Applicaflon MAR 11 2021 �
Planning and Development Services
Permitting Department I
Building and Code Regulation Division St. Lucie County F
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578, Commercial Residential
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PERMIT TYPE: Q cn:'cz) 4�
PROPOSED IMPROVEMENT LOCATION;::
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Address: 19�1&67 Al. I92A
Pro ert Tax ID#: �7 a3 /O 4Od0-OOD-
p y � Lot No,
Site Plan Name: )0,4V2t4Golt/ Block No.
Project Name:
DET t-LED DESCRIPTION OF WORK
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CONSTR:UCTION INFORMATION:
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Additional work to be performed under this permit-check all that apply:
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_Mechanical —Gas Tank Gas Piping _Shutters Windows/Doors
_Electric _Plumbing _Sprinklers _Generator Roof Pitch
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Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: $ �a-l� Utilities: _Sewer _Septic Building Height:
-W,,NER/LESSEE,
;( QNTRACTOR.:
Name .c�?SosYia�i�� S�®�', Name:Ray Reinhard I
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Address: yy40 Al, Company:HBS, Inc. I
Cit State: Address:722 3rd Place
Zip Code: 3V�W e19 Fax: City: Vero Beach State:FL
Phone No. Zip Code: 32962 Fax: 772-778-3514 s
E-Mail: Phone N0772-567-7461
Fill in fee simple Title Holder on next page(if different E-Mailtammyc@hbsglass.com j
from the Owner listed above) State or County License
SCC131151281 I
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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SUPPLEMENTAL CONSTRUCTION LIEN LAW INiFOR'MATION.
DESIGNER/ENGINEER; Not Applicable MORTGAGE COMPANY: Not Applicable i
Name: Name: i
Address: Address: i
City: State: City: State: '
Zip: Phone Zip: Phone:
FEE SIM LE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: 40i9G.6k; o2 ler- A PL(eR--4. Name:
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Address: ?9'6 uS 61wy f .9ff- 3Aao v— Address:
City:._ Ili City: ;
Zip: 3a9�od2 Phone:_ Zip: Phone:
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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 I
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. I
In consideration of the granting of this requested permit,I do hereby agree that I will, in all respects,perform the work i
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 i
"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 i
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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 OF COMMENCEMENT."
Signature of Owner/Less ee/Contractoras nt for Owner Sigriffure of Contractor/License Holder
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STATE OF FLORIDA STATE OF FLORIDA }
COUNTY OF (,� COUNTY 0 F Indian River
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oing inst men was acknowledged before me The for ing instrume wa acknow dge efore me
day of 20AL by this day of 20 by i
x$�Kfl6�L19i�
ame of person m king statement. Name of p rson mak7a!
men .
Personally.Known �// OR Produced Identification Personally Known R Produced Identification
Type of Identification Type of Identification
Produced Produced
ntim lic State of Florida
(Signature of Notary Publi Ic$Wb s P Kap an
My Go mission oe 160278 Sign uogsr�fa otZK Ilt c4#t a arida
. ®iras 11/1alZ021
? Ta my C Englis i
Commission No. m s w M Commission G 906987 S 1
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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