HomeMy WebLinkAboutBuilding Permit Application fall APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ` Permit Number: <
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: a 2)462 578 Commercial Residential
PERMIT TYPE:
Address:M1
Property Tax ID#: �j��` C� C7 L� �1 Lot No.
Site Plan'Namasee Block No.
Project Name: z� i%® �
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Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters `Windows/Doors
Electric _Plumbing _Sprinklers _Generator ✓Roof Pitch
Total Sq. Ft'of':L'n traction: 15 Sq. Ft. of First Floor:
Cost_of'Construction,:;$' y Utilities: _Sewer _Septic Building Height:
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Name Name:
Address: Compan _
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City: Stater Address: ;{
Zip Code: Fax: City: 57u f1 fZT State: '- }
Phone No._ �/,,,.r!' , �r'j /7 / 01 oe n Zip Code: g�] Fax: '
E-Mail: �G Phone No
Fill in fee simple Title Holder on next page( if different E-Mail
from the Owner listed above) State or County License Z j
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 Co mencement is required.
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DESIGNER/ENGINEER:" _Not Applicable MORTGAGE COMPANY: _Not:Applicable
Name: Name:
Address: Address:
City: I A State: City: State:
Zip: Ph ne+�V Zip: I Ph ne:
FEE SIMPLE TI LE O DER: `Not Applicable BONDING COMA Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTO�FF i�idffo5th�d.SAEZpermit:
ermit-to dothework and installation as indicated.
I certify that no work or i sfS tffi on as o`C�inme - ` -
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 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 fuli•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 BE RECORDED AND
POSTED ON THE JOG SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND OBTAIN FINANCING, CONSULT
VRTM YOUR LENDER OR'AN AqqgMgBEIFORE RECORDING YOUR NOTICE COMMENCEMENT.-
1
Z "S E'er
Signature of Owner/Lessee/Contractor as Agent for Owner ;STZA
nature of C ra icense.Holder
STATE OF FLORIDA FLORID o4n
COUNTY OF �0 r-6 Y" Y OF //YY I� 7
The for oing instf�u,,ment was acknowledged before me The for oing instrumept was cknowledg before me
,this� day of MCI VCR? 202D by this day of I�� 20`�. by
omel umr-ie_ JGm�) Arci
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Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produ,�q%%P�i��f R vHHjType of Identification Type of Identjf�ca n � S�•••••• •a EProduced F L DL_ Produced 1�lIJL P.•'nTAgy•
••: i
z c) n = :My Comm.Expires'.
September 7 2. i
UC i3q-Gra 2AEIA7�
Q�e (Sign ture of Notary��Pu(b�lic2St0ate of Florida)'- (Signature of Notary Public-Stay gfi Fioriaa )
;yyfaN Commission No. (Seal) Commission No.Vva - �TFa �-�����
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REVIEWS FRONT ZONING SUPERVISOR PLANS'. VEGETATION SEA TURTLE MANGROVE
COUNTER . REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE .
RECEIVED-
'DATE
COMPLETED
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