HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION,TO BE ACCEPTED
Date: Permit Number:
RECEIVED
MAR 16. 1021
Permitting Department
Planning and Development Services Building Permit Application, gt. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential d/
PERMIT TYPE: t%e-rj r-V A
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Address: 1.152 a ® K �e eC�a6ce RU FT- Pyeru- 3'i 9'4S
Pro ert Tax ID #: 2, 32, �31 20003060 2- Lot No.
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Site Plan Name: Block No.
Project Name: Ke-nne+{ h Iff n*pn fZc rn gde- C
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Additional work to be performed under this permit- check all that apply:
Mechanical — Gas Tank _ Ga's Piping —Shutters —,Windows/Doors.
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 9 $0 + d o Utilities: —Sewer —Septic Building Height:
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NameKtnnr,+k 4-6n Name: —Mrth tI )?rra»crSw
Address:_Ij5gQ ()►C,,pChobe-e- OLD Company:ir-F�u'crsto t"& f-rve'F�
City: fr `trams !RL- State: _ Address: $2 YD 1 )-OwSOwt t 0 i ✓1 c_ 71^a I Z
Zip Code: Fax: City: r'T State:
Phone No. :777 q$S 9627- Zip Code: 3Y`l45- Fax: '7"?- 966---7273
E-Mail: Phone No772 '40/— .% -1-q I
Fill in fee simple Title Holder on next page ( if different E-Mail (1°' �i'ah Co�44- L'
from the Owner listed above) State or County License AJa0 31021
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.
DESIGNER/ENGINEER: — Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: - Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address: `
City:
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 restrictorrpprohibit 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 full concurrency review: room additions,
accessor structures swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
y
"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 NOTIC�7OF COM MfVCENENI IV T.13
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
-0
thisdayof MLq �7'� 2QPI by
Name of person making statement.
Personally Known .'�OR Produced Identification
Type of Identification
Produced
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrvc�ument w� aknowle20ge before me
VVII
this ]—updayo
c, h��, I��An e
Name of person making statement.
Personally Known/ OR Produced Identification
Type of Identification
Produced
-- --•
(Signature of N
ry Public- State o)
(Signature of Notar blic- State o� on a„�- r.
e'v PU AUDREy B. HUMPHREY
AUDREY B. HU14 R�
e
Commission N
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• - h9arch 6, 2023
w�
Commission
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817
EXPIRES: \1arch &, 2023
;. EXPIRES:
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SUPERVISOR
PLANS VEGE A IO
SEA TURTLE MANGROVE
REVIEWS
FRO ZONING
COUNTER REVIEW REVIEW
REVIEW REVIEW
REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED