HomeMy WebLinkAboutBuilding permit appBuilding Permit Application
Commercial Residential
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under this
permit
— check
all that apply:
Tank
.,Gas
Piping
,l� Shutters
9
Plum
Total Sq. Ft of Construction:
Cost of Construction: $ �3 i 7 Oc
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:41 I z ` Permit Number:
x
:N
Planning and Development Services
Building and Code Regulation D'v*sion
2300 Virginia Avenue., Fart Pierce FL 34982
Phone: (772) 462-1553 fax: (772) 462-1578
PERMIT TYPE:
PROPOSED
Address:
ev�C�
INPROVEMENT LOCATION:
Property Tax ID #0dt
Site Plan Name:
Project Name:
n
V L1
is
CONSTRUCTION INFORMATION:
Additional work to be performed
Mechanical Gas
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Electric
bing _Sprinklers
V60
OWNER/LESSEE:
Name f U It ('1 V A
Address:)A=6� � t
�SQYN &J
City:
Lot No.�_
Block No. � 1
Windows Doors
Generator ,'XRaof � � Pitch
Sq. Ft. of fIf
irst Floor: 0 00C)
Utilities: Sewer Septic BuildingHeight.
CONTRACTOR:
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12,
Phnna Nn Lip Loae: x �i u
Name: 1 C ,
r i Company:
_ State: bi Address:.?772,
ZIP LO(ie.d 0�r1� � Fax: City: � .00
E-Mail:
Fill in fee simple Title Hodder on next page ( if different
from the Owner listed above)
Phone No�
E-Mail V, C 111 (Lo i
State or County License
0
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
It value of HVAC's $7,,500 or more a RECORDED Notice of Commencement is required.
� a Soo ra
Fax:
Ir
Lc
State:
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
,,,,,,P.--.
Address: Address: State:
City: State: at Y�
Zip: Phone Zip: Phone: -
FEE SIMPLE TITLEHOLDER, _Not Applicable BONDING COMPANY: Not Applicable
NameName:
Address: Address:
City:- C.
Zip: Phone:zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT-e. Application iS hereby made to obtain a pe I rm It To ao in
I certify that no work or installation has commenced prior to the issuance of a permt.
e worn ana inscaildLjUll = 14 1u1����-M.
St_ Lucie County makes no representation that is granting a Permit will authorize th permit holder to build the subject structure
which i� in eonflict with an a livable Homy owners Assot�atEon pules, bylaws or ,end covenants that may restrict or prohibit such
structure. Please tanst�lt v�thpyaur Home owners Associa#inn and review your deed for any restrictions which may apply.
_..,.....�+sa �.ar.,.,it i .in horphv agree that I will, in all respects, perform the work
111 k.ur«luerdtEun 01 me gro ntmg ❑i viib iryucwd Nu ILP •••, ........., _o. _- --
in accordance with the aooroved plans, the Florida Building Codes and St. Lucie County Amendments-
The following building permit applicatians are exempt from undergoing a full concurrene�► review: room additions,
accessory structures, swimming pools, fences, walls. signs. screen raoms and accessory uses tv another non-residential use
/dNII�' in n2vina twig for
WARNING TO OWNER: Your failure to Record a Notice OT Lommen�CJ1J���L 11#a, 1ca%.�• �•• rs
.I :G... �....��F.lir rcrnrric nfSY
improvements to your property, A Notice of Commencement muse oe reLU1UC= NU�� ����� -• ---
Lucie ounty and posted on the Jobsite before the first inspection. If you intend to obtain financing, consult
wit lender or � atto�ey bef� coyrr�nencing work or recording your Notice of Commencement.T-1- I
y
7
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Signature of CWner/ Besse
STATE OF FLORID
COUNTY OF
AM
this
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Contractor as Agent for owner
ir JUA--w
igKJure of 06-ntrac-tor[License
STATE OF FLORIDA
I COUNTY OF
q.
n to (or affirmed) and subscr-ibed before me of
ysical Presencp or -Online Notarization
day of 202V by
dame of pers* making statement.
Personably Known mm�OR traduced I d e n ti fi ca t! o n
Type of Identificatiofi
Produced
na atary Public- Stat"f-Roridayrl7u'"Iv,r� riQVErxs �
411
�165D3�
Commission No. ` `'? �y�������Li DEC 04 2 0?1
�rfce
�killA I 1ST St�l�
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW I REVIEW
DATE
RECEIVED
DATE
COMP
ev. 57(
LETED
older
Swor to (or affirmed) and subscribed before me of
P ysical Presence or Online Notarization
t �s day of _ n . 202 by
Naffie of person making statement.
Personally Known r -OR Produced Identification
Type of Identificabon
Produrp-d
ignaof Notary Public- State onda )
commissio
PLANS
REVIVIEW
VEGETA11ON
REVIEW
SEA TURTLE
REVIEW
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MANGROVE
REVIEW