HomeMy WebLinkAboutHickey_Building Permit ApplicatinAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
(D
'MW
If,.
Permit dumber:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, fort Pierce FL 349492
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Commercial
PROPOSED IMPROVEMENT LOCATION:
Address: C)c
Property Tax I D #: )41 S --i c) rJ � 0 1 q — c>c> (o sitePlanName: f11CVijA.1t&1AjinLL
Project Name: _4t r � 1%.l.l 1Zc� � �o �t r►r �rnvn�
DETAILED DESCRIPTION O:F \A/0-RK:
t
n.s a,1I
N WwSlec ricAll'I
ete r
S1i,
()q a"
Residential -14440
'0
1-i'l 0 -Ar
Fl
se%s l.lS 1 Yl �� ri �1
4 11 �Snlio CL vrY�-tc� r6LW(�l s .
eam Elect cal Meter
CONSTRUCTION INFORMATION:
Additional work to be
performed under
this permit- check all
that apply:
Mechanical
_Gas Tank
� Gas Piping
� Shutters
Electric
1 Sprinklers
Total Sq. Ft of Construction: O� � � D
_Plumbing
Cost of Construction: $
z. Iso. D�
Generator
Sq. Ft. of First Floor:
34q 97C
Lot No.
Block No.
Windows/Doors Pond
Roof 75 14 Pitch
Utilities: � Sewer � Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name It�
Name:
ei�.lX.
Address:-t-cquiU)OJL
Company:
o
�'tCity:�-f , Stater.
Address: 119 ZE
r4- a,
�I I Vol
Zip Code:Fax:_
city:;30rf g-4, Li.I.C_U
State: _RL
Phone No.
0
Zip Code: 3`t"1�o1
Fax:
E-Mail: li'Ir1hDO co M
a\JCLh
Phone No "I1
L-
Fill in fee simple Title page ( if different
E-Mail(Il!1(��46Y
hav-ex� r-0o-��. Co m
from the Owner listed above)
State or license
County
CCC. I S S I UP
Sq
ti
If
value
of
construction is
2500 or more, a RECORDED Notice of Commencement is required.
If
value
of
HAVC is $7,,500
or more, a RECORDED Nonce of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: .�-` Name:
Address: Address: �
City: ate: City: Stye:
Zip: Phone / Zip: Phone:
FEE SIMPLE TITLE H DfRa Not Applicable BONDING COMPANY: _Not Applicable
Name: Name: �
Address: .. �` , Address:
City: City:
Zi Phone: ?ice Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
1 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 conlict 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, th(:-t 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, walks, 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 paying twice for
improvements to your property,. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with fender or an attorne before commencing work or recording Notice of Commencement,.
Signature of Owner/ Less'ee/contia�or ais Agent for Owner j Signature of Contra ctor/License Holder
STATE OF FLORIDA STATE OF FFORfDA
COUNTY 4F �..�..1CI �coonCOUNT 11111
Sworn to (or affirmed) and subscribed b0ore me of Swn to (or affirmed) and subscribed before me of
o
Physical Presence or Online Notarization Physical Presence or Online Notarization
this I�4_ day of 2024 bv this JRdayof W(A-14 2024 by
LO i I � OL01'.- � �k..-�.i.�0 M&rw IIIo M
S
Name of person making statement. IL Name of person making statement.
Personally Known �OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
uLfA I.
ML FORM
win
(Signature of Notary Public- Staff Lure of Notary Publi-c-
Notary Publ€c State of F1 'da Notary Public S#m� of �ta�da�
Commission No. ;� ��Alexis 1.. Reining om fission No. � Alexis - ��y Commission H �€11918� %OF
My �p�rr�rn� MM 118't87
��vf �Expires 04/20/2025 �...� � 1 q ! Q "`� � Fxpl�s 4412012025
4 1011� L O 1
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 576
0