HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICA 2LE INFO MUST BE COMPLETED FOR APPLICATION T
Date:
D BE ACCEPTED
Permit Number: aNa3 -610YI
Building Permit Application RECEIVED
Planning and Development Services MAR 10 2021
Building and Code Regulation Division Perm lttlna partment
2300 Virginia Avenue, Fort Pierce FL 34982 St Vie County
Phone: (772) 462-1553 Fax: (772) 462-1578 Commer ial Residential
PERMIT TYPE New Wn 'u Gkon
�
Address: 010 Oral e ' i4ye- Pl( rc� P 3Z�
Property Tax ID #: - �� - 00
0 / 600,qLot No.
Site Plan Name: Block No.
Project Name:
W
V -
h au
Additional work to be performed under this permit -check
—Mechanical _ Gas Tank _ Gas Piping
,'✓_ Electric _%,/P'lurobing _ Sprinklers
/
Total Sq. Ft of Construction: `� .-E 3 S -0
Cost of Construction: $ 2- 00 K Utilities
that apply:
Shutters ✓Windows/Doors
Generator _\ZRoo.f. • Pitch
Ft. of First Floor:
_Sewer /Septic Building Height:
'y ,: r�x NO
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Address: 1'70_0 Qr_ar1Q6_ A-Vt
ChIompany':" . _.. ...
City: State: r
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Zip Code:g LIS_ Fax:
Phone No.17a - 3 3,91 r a ji
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Add`'ress:
City_ i' State:
ip Code: " - Fax:
Phone No
E-Mail: M CArCt- 31V �1 U-0 «�
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
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.
.a.
IN Na
TOR
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MORTGAGE COMPANY:
_ Not Applicable
_ - _
DESIGNER/ENGINEER. Not jApplicable
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:
J
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the worK and mstaiiauun d� [UK.d Leu.
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 restrictorrpprohibit 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 FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Les�e�Leontractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF 5�-. \-v
The forgoing instrument was acknowledged before me
this\a day of dr`n+C , 20a.\ by
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this day of , 20_ by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced V-�i 9�1 L
(Signature of Notary)kdb
Commission No.
REVIEWS I FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
o ,t, )Public -State of Florida
Notary
M�����' sionExpires
r s J n 2S, 2025
. Expires Jan 28, Assn
ded through National Notary a
Personally Known
Type of Identification
Produced
OR Produced Identification
(Signature of Notary Public- State of Florida )
mmission No.
ZONING REVIEW I SUPERVISOR REVIEWI REVIEW PLANS I VEGETATION
(Seal)
SEATURTLE I MANGROVE
REVIEW REVIEW