HomeMy WebLinkAboutPermit AppAIIAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date f-2o -2t
Building Permit Application
Planning snd Development Services
Euilding and Cade Regulation Division
BAA Virginia Avenue, Fort Pierce FL i4982
Phone: (772) 462-1.553 Fax: (77?) 462-1"578
Commercial Residential
Address: /07 2 { f- Oceon
Property Tax lD #:
Site Plan Name:
"020 -oo0-tat tta. 3 /
a ut Block No. F
Project Name
Y
or71
New Electrical Meter Second Electrical Meter
CONSTRUCTI ON I N FORMATION :
Additional work to be performed under this permit - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Flurnbing _ Sprinklers _ Generator
Windows/Dr:ors
Roof
Pond
Pitch
"Iotal Sq. Ft of Construction q//L/k
Cost of Construction: $ffoo,oe Utilities: ,YSu*",Septic Building Height:Zl
lf value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
lf value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
pERMtT AppLtCATtON roT: flemo /f fiart
PROPOSED IMPROVEMENT LOCATIQIII; , r
DETNLED DESCNPT}AN OF WDBK:
OWNER/LESSEE CONTRACTOR:
Name flewl Or/a " /a
^ddress:
22O I -ft lcf/ra -Ct
City:flur- t State ft
Zip Code 3ry?a Fax
Phone No. T0 3' gIl:-ZZSt
E-Mail
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name
Company:
Address:,/O ,/taA faenc.r f/.
City M State a
Zip Code .2c/7 f 7 F^*,772'2)2 2)?/
Phone No ? 72 - 2lO -7 7 /f
r-\aait a /q rd, (m ; h ;nc e ya/ao - com
State or County rir."r. C 8C /2 f l78l
/'"' tt -# Permit Number:
qzr- 37t -26vsT. LUCTE
K
Sq. Ft. of First Floor:
[Jctary Pubiic-State of
Commission # GG I
KATH I'J D'AIVi
lv'l Com rn ission
mber 1.4,
id
I
Name of person making statement.
ctor,der
n
or
and subscribed before me of
Onl
Ado, f>yn
STATE OF FLORI
COUNTY OF
Personally Known _ OR
Type of
Prod
STATE OF FTORIDA
ioururv oe - Me^ \-h n
Personally Known OR Produced ldentification ,''
as Agent for Owner
Public- State
commission No.@lDbq
Sign
r:f
or
by
r4
P
and subscribed before me of
Online Notarization
of Ownerl
Name aking statement.
Type of I
KAT FI B t1 D
Pot u bii ^ C+^arY
Commi ,$lon u
[r1 CC mim SS on
S i)tem !+
p ires
2A i3
a o0
of
on No.
ry Public- State of Florida )
(Seal)
MANGROVE
REVIEW
REV'EWS FRONT
COUNTER
a.@ffi{
ZONING
REVIEW
SUPERVISOR
REVIEW
.Wi?aFE{.;:;
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
plicable
State:
PhonePhone
Address
zip:
City
NEER: _ Not Applicable
State:
MORTGAGE COMPANY:
Nam
Address:
DESIGNE
Name
City:
_Not ApplicableNotBONDING COMPANY:
PhoneZi
Name
Ci
zip
Ad
FEE SIMPLE TITLE HO!-DER:
Address:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the
I certifythat no work or installation has commenced prior to the issuance of a permit.
lation as indicated
St. Lucie Countv makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with anv applicable Home Owders Asiociation rules, bvlaws or and covenants that mav restrict or prohibit such
structure. Please consult with your Home Owners Association and review'your deed for'any restrictions which may apply.
ln 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,
accessor\i structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residentiai use
WARN ING TO OW N ER:You t fa lu re to Record a Notice of Commencement may result in
be recorded
paying
in the
twice fo
mprovem ents to your prop erty A N ot ice of Com me nce m ent m ust pu blic records of st.
Luci A Cou nty nd posted on +
L h e o bsi te b efore the fi rst tn spe ction.f you nten d to obta n fi nan ci fl8,con s ul t
with le nde r or enci WO rk or reco rdi r Com m en
sr\ru ENTAL CONSTRUCTTON LrEN LAW TNFORMATTON:
-/-