HomeMy WebLinkAboutBuilding Permit App 17MAY2021ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date.
Permit Number.
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-lSS3 Fax: (772) 462-1578
Address: 31OS 'SUNRIS'E 6J,,VDTS id Jej C k' '6
LeRal Descrij)tion:
Property T
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Commercial Residential Y
axlD#:.2'f`�•ZCJ"lD��'��loU'00�1 ,a
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Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side:
Left Side:
DETAILED DESCRIPTION OF WORK:
C6NVERT 1 950 APA? 13RCle.. `rn iafkcK GL.EcTV,.w1c-.a SiERVICaC.-o -Tu
A �NTIiC SIDE i3Y S1Al: 12o/2y0 V&L-r 511\*LI5 ?14F):5E*
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CONSTRUCTION INFORMATION:
AMitionalwor to e er orme under this permit— c ec a app y:
[:IHVAC Gas Tank :Gas Piping Shutters � Windows/Doors
DQElectric 0 Plumbing Sprinklers � Generator � Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
on
Cost of Construction: $ �. Sao. Utilities:1- _Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name (T' A Rif EL W ODD Name: l.'HAR�ES �. �.0ltlE
Address: �'I �`I O tz P (� E S'q G Lpj Company:cHAR[.ES I�.d wE �1-.EcTRIC3 T�.�e,
City: F o g--r P 1 E R C F, State: L Address: �sz 8)VP_ OF pro
q98!Z
Zip Code: 3Fax: City: FORTFORTpigRaE State:l'L
Phone No. Zip Code: 3�i9Ai q Fax:
E-Mail: Phone No�9(a
Fill in fee simple Title Holder on next page (if different E-Mail• C ouJP � lee+rl-C4 nd co 10
/ • �'aM
from the Owner listed above) State or County License: #,20-_
OE9064015111
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRl1CTION LIEN'LAW:,'...INFORMATION:
,,-:,..
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.
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 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
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
eommencin work or recording Notice of Commencement.
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Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORID � . .
111
COUNTY OF St UA C If2 COUNTY OF
The forgoing instrument was acknowledged before me The fo going instrument was acknowledged before me
this � day of , 20Z� by this �day of {� 202 � by
k"ef) \N )e-"01
Name of perso making statement Name of per on malting statement
Personally Known �_ OR Produced Identification Personally Known ^ DR Produced identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Publi - to of Florida) (Signature of Notary Pub c- §tate of Florida J
Commission No. � (Sea 1) Commission No.QO�� 2-��(Sea l)
J JJ J
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
Notary Pubfic StaW of Flom
a �ANhrins LA rtin #r%n
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rV1Y 10�111111VWQW% 1 k %3%.
'df Expires 27/2
Notary Public Stan of Fkxi*
T Sabrina M Arrington
J,,,� Expires 08127/2023