HomeMy WebLinkAboutBuilding Permit Application All APPLICABLEINF,MUST BE COMPLETED FOR.-APPLICATION TO BE ACCEPTED I
Date: �� Permit Number: � ��
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Building Permit Application
Pldnnrng-and Development Services;
Building-and Code'Regulation Division
2300 Virginia Avenue,Fort Pierce F!34982
Phone (772)462-1553. Fax:(7Z2)462=1578 Commercial Residentia4.
PERMIT TYPE,,:
PROP05ED IMPROVEMENT LOCATION;
_. _.__
Address: q s
Property TaxlD#: 0 U . I 060 — cj LotNo;l I
Site:Plan,Name; I)Ct ram: Rk can-S. _ Block.No.— —
Project Name: 0 6
DETAILED DESCRIPTION OF WORK:
NO a
CONSTRUCTION INFORMATION
Additional work to:be performed under this permit—check all that-apply:
Mechanical Xplurn.bing'
s.Tank _Gas Piping _Shutters ^Windows/Doors
�ctric Sprinklers YGes�erator Roof Pitch
TofalSq.Ft of Construction: Scj,Ft.of First Floor:
Cost.of Construction:$ r' 00 a Utilities: _Sewer Septic. Building Height:
OWNER/LESSEE: CONTRACTOR:
Name . YG`rti .b i CAS Name: t 1n"nM1[g {CcCt c�r� c.
Address:. a ys 'd Lj c..a Company: k
City: E04 ztcx State: I Address: 7: 5 Lo 15 C`
Zip Code: L q 41 Fax: W City:Q Stater
Phone No. �7 i 4 4 i3.7 Zip Code:.:. Fax.
E-Mail: f`Q k I _ . 061 b i� �ist- S: i cis Phone No `7 z1 3_.1 2,• ? 7
Fill'in fee simple;Title Holder on next page(if different E-Mail L b fe l t s7b 9(_ r,;,�� I„0-0. c y rn
from theDvvner listed. above) State.or County License
If value of construction is$2500 or more,a RECORDED Notice of Commencement isrequired..
If value of_HVAG is$7,500 or more,a:RECORDED'Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGMEER. otApplicable MORTGAGE COMPANY': _ at:Applicable
Name: Name':
Address: Address:
Clty State: City; . State,
Zip: Phone' Zip: Phone:
FEE SIMPLE TITLE;MOLDER: _Not Applicable BONDING COMPANY: ";. of Applicable
Name: e, Name:
Address: .. -. 1 Yt .c Address:
ity C . :c city.
l
Zip1t Phone: -)7 �� - ✓ Ztp:;_ Phone:
i
OWNER/CONTRACTOR AFFIDVIT:Applicationis hereby made to obtain a permitto 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 permitwill autf orize the permit holder:to build the subject'structure
Which is in conflict with any applicable Home Own ers�Associaiion:rules,bylaws or,and covenants that mayrestrict or prohibit such
structure.Please consult with your Home Owners Association and'rWewyour deed for any.restrictions which.may a.pply..
in consideration of the'granting of this requested permit;I do hereby agree that"{will,in all respects„perform the work
in aceordance.with the approved plans,the.Florida Building Codes and-St.Lucie County Amendments.
The following bu lding,permit applications are exempt from undergoing a full concurrencyreview:room additions,
accessory structures,swimming pools,:fences;wa(ls,.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 OBTAIIN FINANCING,, CONSULT
WITH OUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF'COMMENCEMENT"
SignZCO
:'of own /Lessee/Contractor as Agent for Owner � Sig Lure of Contractor/License.Holder
i
STAF FlCI 1 - : ; STATE OF FLORIDA
COUNTY OF ct h,, :+� i COUNTY OF Ae'-L
The forgoing instrument was acknowledged before me The forgoing instrument'.was acknowledged before me.
this:.2�Sj day of tic, 20�p 1 by s thiiss 2 day of_ &F2 120 2i by
Cn Lam: i t 1' ,4:CAz Ye4r^v
Name of person making sta exit. Named person making statement.
Personally Known OR Produced Identification. Personally Known OR Produced Identification
Type of Identificati IV1IV'6N1/�d i Type of identification
Produced �ratxq +bic strslr c!t wrids: ii Produced
Traci Vein i LEE
eq.a Farce
MY C,bfimnSM GG 43T771 ors 1210812023 GG 93I77t
028(Signature 'f'Notary a ic-.State of Florida) {Signature of Notary .
Commission No. (Seal) Commission:No. ("Seal)'
I ,
REVIEWS FRONT ZONING SUPERVISOR l PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW t REVIEW REVIEW REVIEW"
DATE i
RECEIVED
DATE
'COMPLETED i
Rev. 2/7719