HomeMy WebLinkAboutWOODY - PERMIT APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE: 'kook .rep\acRmev�t
PROPOSED IMPROVEMENT LOCA OON:
Address: �Z�O RS-S2CuQ. 0 YQQK T)t.
Property Tax ID #: 3 1-1 22 " (o O � - nn Q1 - Q ice``) - q Lot No.
Site Plan Name: � .!s,gz i� C raP i- Vax,. �\ A U4 Block No.
Project Name: W 00&,A lLL
I DETAILED DESCRIPTION OF WORK: I
CONSTRUCTION INFORMATION:
0
Additional work to be performed under this permit - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shuft�rs
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: J, 300
Cost of Construction: $ I ?) I()0 0 .
_ Generator
Sq. Ft. of First Floor:
Windows/Doors
✓Roof 9 L12c Pitch
r
Utilities: _Sewer _Septic Building Height: �
OWNER/LESSEE:
CONTRACTOR:
Name
Name: 1:rq,.K �-42.cn
Address:. 11\[1 Cl.Ob�r J� lJ(QO_Il. SJ\j- •
1
Company: ll.- p �onfinn 0'.V%A '� !6+rudon
City:? r S�a. Ljr�%Q. State: �L
Zip Code: 39 9 R(a Fax:
Phone No.
Address: 38p0t4 L3UYY �.lGXP .ID
1
City:-RL*A Ekatl)n %drrlQns State:7L-
Zip Code: 3 341 LQ Fax: 5(ok- g35-Cl3Y4
Phone No 56 I- 4CA`-1/-�1I
E-Maik
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
11
1P.OMt»l lY bQl/SouTif.nt
State or County License elt_ I3 a �`FOa
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.
yyy #
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
_
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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
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 IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
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 NnTICF OF cnMMFNCFMFNT
Signature of Owner/ Lessee/Contracto Agent for Owner
Signature Co
s
of tractor/License Holder
STATE OF FLOI�1
(�
STATE OF FL D n
"p��
COUNTY OF %x &
COUNTY OF (� Pgjex
The forgoing instrumen was acknowledged before me
The forgoing instru ent was acknowledged before me
this day of o 20 y
this day of 2 by
I I VA AA
Name of person making state me t.
Name of person making statement.
Personally Known ✓ OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Produced
I
Produced
(Signature of N tBl; Ic- 5tatleK>If SdtlY R
c�'
i
(Signature of Notary Public- at on a
eP� a A HELLE SAWYER
-? • `-. Notary PuU is rate of Florida
; commi ' N�898
Commission %:,
s W
,�;.*,`. N ary ublic - State of Florida
No ;3 . &pire , 2020
Commission No. i"3A' Ission XGG 32898
,7 ;/ h
Bonded through National Notary Assn.
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- . u'r �Bo My Comm. Expires l No 22, 202
Bonded through National Notary Assn
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. L/ // 17