HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number.
I
RECEIVED
- --- Building Permit Application MAR 2 2 2021
Planning and Development Services permitting Department
Building and Code Regulation Division 5�. Lucie/County
2300 Virginia Avenue, Fort Pierce FL 34982 /
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential VVV
PERM IT TYPE:
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Property Tax ID#: ,� �' � I '�� /•� � 7� /, Lot No.
Site Plan Name: Block No.
Project Name:
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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 �oof --Pitch
Total Sq. Ft of Construction: 2240,0 Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer �_Septic Building Height:
-
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Name Name:
'"'f�0•F�-sr���� b f t S Cf� -
Address: "7./06
&rtn% _ V-� Company:
City: Frj�Q rC'L State: L • Address:
Zip Code: q!q Fax: City: State:
Phone No '�2 > _1 ZJ " $7 80 Zip Code: Fax:
E-Mail: 1 (%/llr1SC6 %q/oS 01 .1G// 46/►7 Phone No
Fill in fee simple Title Holder on next page( if different E-Mail
from the Owner listed above) State or County License
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.
PEW
DESIGNER/ENGINEER: _Not Applicable 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 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 applicab.le Home Owners Association rules, bylaws or and covenants that may restrict Y r prohibit such
structure. Please consult with your Home Owhers,Associatibn and review your deed for any restrictions which ma a Iy
In consideration of the granting of this requested permit, I do hereby agree that Lwill; 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 L NDER OR AN! ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:"
;Signa
re f, wn Le ee Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OFF ORI STATE OF FLORIDA
COUNTY OF COUNTY OF
The f going instr men was acknowledge before me The forgoing instrument was acknowledged before me
this day•of M1,2�by this_day of 20_ by
V) 149 _m".. c .
Name of person daking statement. Name of person making statement.
Personally Kno OR Produced Identification Personally Known OR Produced Identification
Type of Identificatio -- Type of Identification
Produced ` Produced
0, 1
(Signature of N ry Public State o FI rida) (Signature of Notary Public State of Florida )"
Commission Commission No. (Seal)
GO 300817
9F 'c Unde!'tutor-
REVIEWS yyPRONT - ZONIN PERVISOR PLANS' V:REVIEW
ETATION. SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW ' ' REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.
.......'11;: 1AUUMIZZ 1 0.muivitNKLY
MY COMMISSION#GG 330817
EXPIRES:March 6,2.023
(;ended Thru Notary Public Undewt wars l'1