HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ®3l 'gI Do . Permit Number:
I'
�. law
t
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
M � � - :
'v. r- ',' tip
-.�..._� -
Address: 1ae O a�? ObyiN
Property Tax ID#: y��kslllomkaoona Lot No.
Site Plan Name: Block No.
Project Name:
ie
1
AC a '�Q UeS
Additional work to,-be performed., under this permit-check all that apply:
_Mechanical Gas Tank ^6as Piping _Shutters Windows/Doo.rs.
_Electric Plumbing _Sprinklers —Generator,- `Roof. Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ a,aOl7 • c�17 Utilities: —Sewer —Septic Building Height:
_E
Name c. Name: ,R �edili t ) NPe
Address 1bLp Q 1� . :f�ipap_ �� � 10� I Company
City �,��r.50 State: ��{I AddresS 401,1Afl►rt`eQ��r�rzG�l7
Zip C66E Fax _ City $ State:
PhoneNo Zip ode: "��a Fax:
E-Mail: t�N):5 CA ,t,�® - C0' 0 Phone No 17 7, . 1r k �3tl`�S-
Fill in fee simple Titlelder on next page( if different E-Mail 1 tvc C R ug Ai
front the Owner listed above) State or County License Cr-C.W Ai.59
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.
Frri I ON i
DESIGNER/ENG : N_o7Appricable
- - - .
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 AFADVIT: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 IMPROYEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST DE RECORDED AND
POSTED ON THE JOG SITE BEFORE THE FIRST INSPECTION. IF YOU IRIS D TO OBTAIN FINANCING, CONSULT
WITH YO R IXNDER OR AN ATTORNEY BEFORE RECORDING YOUR N014A OF COMMENCEMENT."
Sign e of Owner/Lessee ontractor as Agent for Owner Signatur of Contractor/Lice e Holder
STA E OF FLORIDA STATE OF FLORIDA
COUNTY OF �I1 A,� a COUNTY OF
The for oing ins ent was acknowledged before me The for oing instrument was acknowledged before me
this day o Z0.`� by th�y day of r i +�_, 2C4nP_1 by
Name o person making statement. Name of person making statement.
Personally Known OR Produced Identification�� Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
ignature of Notar n ture GRA of Notary Public- State of Florida
HNA
LASHA I M- HMING .,,•z _
Commission No. MY
Commission ( ;, ;,:^'u;; LASHAHNAING4HMING
20 2022 Commission No. �:.
P EXP s ;—MYCOMMMSION#GG 275W:W SWedlhfuNotaryPuAt[cUndelNallerS ly ai P`J EXP
IRE&Deoember20,2022
..•. BDndedThruNo1WPLq)9c Und&mbm
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGyET�i 1 VE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
s