HomeMy WebLinkAboutBuilding Permit Application�l
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVED
. MAR 18 102f
Building Permit Application
Planning and Development Services Permitting Dapartment
Building and Code Regulation Division St. Lucie Courrty
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE: \ 1
Address: CO-V (o M & W61 — W ""( (-A
Property Tax ID #: 0L4 � �O D 3 - iJ a b 7 - ��d ' v7- Lot No
Site Plan Name: Imo• Block No.
Project Name: tkdwaq
/ . / rn I A An -,-- _ . L A I I .,%
Additional work to be performed under this permit - check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters indows/Doors _ lJ
Electric = Plumbing _Sprinklers _ Generator ,-Ro6f 7 la - Pitch
Total Sq. Ft of Construction: ;Soo Sq. Ft. of First Floor: 34
Cost of Construction: $ 301000 Utilities: —Sewer _Septic Building Height: 161
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Name l�i9Sorti h�SL
Name:
'5Ad d re'ss"�I' l l g.; lJ ; s �e�
FCoym Pa:nY;
vGrty ;for' 5.4 16
State:
Y
C. r .. State:
, _
Zip Code ;:>';` Fax: ��
Phone No. 7 - 3$� - 7C)
Zip"Code: , :,a.; :J;� �,a`jr:. Fax:
Phone No
17.�
E-Mai1:CAQS�� Pg1rKg0/UDP.�'f7'GC/R/Q1hlt�� '��
Fill in fee simple Title Holder on next page ( if different
E-Mail
State or County License
from the Owner listed above)
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
MORTGAGE COMPANY: _ Not.Applicable
Name:M.%0_k4e1 4rdaor` k Des!& rq
Name:
Address: ?14N fwy A I A 6&. d.--- 301
Address:
State:
City: T_�_ IQn karboj r Riggek State: r-
City:
Zip:; q S) Phone 3P.1-90a- 3&-g1
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
Association bylaws or and covenants or prohibit such
hat wh
is in
swhich chtrict
may ap.
tructure. Pleasecconsult with yourr Hlome Owners Assiidrreview your deed or any restrictions
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,
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 TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
.IMPROVEMENTS
POSTED ON TIME JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
VofOwner/
Sig re Lessee/Contractor as Agent for Owner
Signat e f Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA / t4C;e
OF S l�
15
COUNTY OF ( ld� ; e
COUNTY
The forgoing instrument was acknowledged before me
The forgoing instrur,�e t wps acknowledged before me
%C� -L 201�L( by
this I? day of Ayre k 1200 by
this -p-- day of ,
Name of person making statement.
Name of person making statement.
Personally Known _-----OR Produced Identification
Personally Known OR'Produced Identification
Type of Identification
Type of Identification
Produced
Produced
r Public Sta �' 1 GYi'da
gnature of Notary )1
(Signat� of Notary Public -State gfl�tti� �)
0;
\�� ..)
G95b6/ 6 m.#GG95661
Commission No. _. �..�.ea
' Feb. 9,
//Gy // j :r � I Comm.#GG
0.
ommission 1Cfo (o ';' ' a� • Feb. 9,
Bond
REVIEWS FRONT ZONING SUPERVISOR.'
• .'RLANS VEGETATION..., SEA TURTLE, , MANGROVE
REVIEW `REVIEW `REVIEW
COUNTER REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.
1
4
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