HomeMy WebLinkAboutBuilding Permit (2) IF
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 01".7
• • Building Permit Application RKEIVED
Planning and Development services JUN 18 101,
Building and Code Regulation Division
Permitting pepartment
2300 Virginia Avenue, Fort Pierce FL 34982 ele County
Phone: (772) 462-1553 Fax: (772)462-1578 Commercial Residential 5t"
PERMITTYPE: t�ZtvAc T7JI wooer
Address: n> �a S :UJ00� L �1 T c=►ZLr` t otz.�a 3 4�i S 1
Property Tax ID#: 1.301 - 1,� -O n 4 1 O 0 0 - T Lot No. t
Site Plan Name: Block No. I?K
Project Name:
DETAILED DESCRIPTION OP WORK: J
CoN s Z,4c_F too Fr 4/cobo -t Ft.nIC� �'� _ 0 Jjs
01
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-CONSTRUCTION INFORMATION:
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
Total Sq. Ft of Construction: t00FTX Sq. Ft. of First Floor:
Cost of Construction: $ 1000,oo y Utilities: —Sewer —Septic Building Height:
Name G -9- S Name: (9(tu777
H 1`[TL
Address: 5��� LASrwDo� �RlL1L Company: tr 11Y $ 1�►-( IN rny1►J�(r
City: fi0 QT �1 �� State: Address:3 3 3 SAy I
Zip Code: 34`1S ( Fax: City: PUYLl- 5Stater
Phone No. �� i- 5g$6 — I kL J Zip Code: �y
E-Mail: III k cc, . Q v/�►too Cv rN Phone Now 11 Z- '6 0-1 S� Z-Ke �Nit
Fill in fee simple Title Holder on next page ( if different E-Mail i' V I.3 W C(rv, " (dsi(.JFvLJ1,M In4 I-Ad+u+t-(0
from the Owner listed above) State or County Lic�n(3(_0&0 IL{-7 C)
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.
` MENTAL ONSTRU l , , ; . _ v
DESIGNER/ENGINEER: of 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 IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BFFOKE TY.E F!RST INSPECTION. IF Y04f1NTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECOIiui`!G !r011!_1R TICE F C M NC MOT."
Signature f Owner/Lessee/Contractor as Agent for Owner Signature of Contract /L tense Holder
STATE OF FLORIDA STATE OF
COUNTY OF COUNTY OF FLORIDA W4,-L r
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20_ by this_T day of 'SUDV"L , 20___{i by
ay
Name of 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 Produced
(Signature of Notary Public-State of Florida ) (Signature of Notlly Public-State of Florida )
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE M D
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW `ei9W _
DATE
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