HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
los.oa3-6
Building Permit Application
Planning and Development Services
Building and Code Regulation Division /
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
ON P
IT MINE
WN
MEN IMM
Address: OD o 1 ;;ye A-v,,g vrl- s4,
Property Tax ID#: 314 1 I Lot No.
Site Plan Name: Block No.
Project Name:
Me
r .c ��n ,.,s, "i-vxr_.'w1firKMr�a- :? 3� � •'3
�: -.r'` ..z -5-,5"k' sky57` 7:
p
`^ - - rr
,_,_F. .� _a-�' :- ';_. �i ziT..�"2+. 5...�;.` 2 .5�w- .F, "y .za�"a�..�
— ^ S�4t1 �►� i�dlP���� �.,r� �l�e e.�r ►C4 C�np�.(�-+
10 2C M( n2 �✓ �b�q� L Uty- VD f`4�fe—
L(I A d(SC C- �' Cp ),A 'C1�/ 5
�^r3.,�. ,�,ss ',v •_ {��`?[+, ,�`x �s'� i31x'xzr-^FC f H '�.. t" —� cS� ss"7� •-�"z.- �S: � fi �' � i.
,c 5 i '(13`� � '�le ��,, `` '.,, �y"g, a 4 i �"� - !„ k .�s"- =tea.- ,'-
,
,��-,_I r s a ;�� c, c � a_. x, a- ��3,� amp�"m a
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
Electric _Plumbing Sprinklers _Generator _Roof Pitch
i
Total Sq. Ft of Construction: /06 Sq. Ft. of First Floor:
Cost of Construction: Utilities —Sewer Septic Building Height
Oy'-€ �,. _t - ' `Y �-`*`
Name > Y+W CL)rr;n Name: A)1Y 1�n
Address: 0 /1 u.e Company: (� lJ �/' 1� ��P �►�� -Inc-
City: 60- S-, �✓C)iQi State:•FL Address: 0 XV_e_ 114 V-t—
Zip Code-:.�Y�JoL _Fax, City r� L✓�� ;; State:-F—L
"y _;a �� ( Zip Fax i
E-Mail: C��I'1n.Q .0 fi Phone Nolf-
-r �,.... . 1..., /
Fill in fee'simple T t1e.Holder on next page( if different E=Mail -- CJ ) Q'� PC'(T�C,
from the Owner listed above) State or County License L.. Q 3 0>63V d
If value of construction is$2500 or more,,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,506 or more,a RECORDED Notice of Commencement is required.
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 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,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 IMPROYEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
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."
X A/v , N 10 �'
Signatu of Owner/Lessee/Contractor as Agent for Owner S' ture of C ntractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF .o COUNTY OF
The forgoing instru ent was acknowledged before me The fQr oing instrument was acknowledged before me
this�`[ day of 20 by this May of 20� by
l\
Name o erson making statement. Name of pe on making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
A6)
at re of Notary Public-Stiite of Florida) ( nature of Notary Public tate of Florida )
Commission No. (Seal) Commission No. (Seal)
r= w�,
REVIEWS f R OR PLANS V T• IC 1 rWOPN�A ROVE
' I REVIEW a, �`� EW
DATEYPub6c
RECEIVED
DATE
COMPLETED
ev.
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: a�d5' dad
s RECEIVED
Building Permit Application WY 1 1011
Planning and Development Services '7rmittk-9 D�-aartmert
Building and Code Regulation Division 5L Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
3 � —M .:4 r �.y t� rr- �{v�y� ,; -, �.su.��'e€.-:ems e� �..� f..�- � x SAC .� •..,ti�,.t
Address:
PropertyTax ID#: ` " 5`d V da�oCe' c�a4.� Lot No.
Site Plan Name: Block No.
Project Name:
tS
M `.�+.
1 4.
Additional work to be performed under this permit—check all that apply:
_Mechanical ,Gas Tank _Gas Piping ^Shutters _Windows/Doors .
lectric _Plumbing —Sprinklers _Generator ^Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ O d Utilities: —Sewer —Septic Building Height:
Ff
Name Name:
Address: h�P Company::;
City: Itt ` State: Address:. -
Zip Code: S Fax: City: State:
Phone No. 5 Zip Code: Fax:
E-Mail: L�f 1 ko+Mt � I (ON 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.
y .�.�..s.-�-� � = - �4"'s^zr,- ��` -..;..._E„'.. 3-':c�rr""'=-r,.. ��•' .aev .r_�`�_ +��:� �'� ' � s�3•�r�,��_ si.
s '— -� ,
DESIGNER/ENGINEER: _Not Applicable A 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 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,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 F!RST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YO LENDER OR AN ATTORNEY BEFORE RECO�RANG Yee IIR NOTICE OF COMMENCEMENT."
Signatur of Owner/Lessee/Contractor as�Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of ` \9.4 203.1 by this day of ,20_ by
Name 6f 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 [ L. Produced
(Signature of Notary blic-State of Florida (Signature of Notary Public-State of Florida )
NtNA GIVENS
Commission No.\—\\-\ :c W.
r:. NotaryP a4)5tateofrl°nda Commission No. (Seal)
Commission HH G86352025
f y Qa m Expires Jan 28,
' o ded throuBh Nat
REVIEWS FRO SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUT REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.