HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAl I AP PU ABLE I N FO M UST 8 E COMPUTED FOR AP F Ll CATION TO BE ACCEPT E D
Date: —
9z L LITCXE
Permit NUMber`
Building Permit Application
Planning -and 0evelopment Servjce5
1501ding and Code R u il Da v&00.
2300 Virginiv Avenue, Fo(r Pierce FL 3499.2
Phone' (7721462-1553 Fax:. (772} 462-157
PERMIT APPLICATION FOR -
Commercial
VKU1wU E� i[vIIPR I E IE[ T � Ail - —
Address. 4 � v l
Property Tax I D #:
Residential
Site Plan Naive-
Preject Narne 1
DETAILED DESCRIPTION OF WORK:
%o n Kc
mew H ect ri ca I Meter Second E1 ectei cal ete r
_J
Lcrt N o.
Block N o.
CONSTRUCTION 1 ORMATIO :
Additional work to be performed under this perrnit —check all that appiY:
—mecharlica
Electric
Gas Tank
Plurnhing
—Gas Piping
Sp i nklers
Total Sq. Ft Df Construction:
w
Cost of Constructierr: — L J_ -
OWNER/LESSEE:
Name 1 _C_i;
State
Zip -00-de; Fix= —
Ph -one No.
— 5 hutte rs
Gene rate r
I win(jowV1):o1oT'5 PoTid
Sq _ Ft, of r i rst Floor.
U t-11ities: _ Sevuu r _Septic
Roof Pitch
Building Height:
CONTRACTOR,
Na rne:ell
r —
Ail -dress; by
city
State;
Zipade, `! — _ Fax:
Phone NO �r
f �if�er�rtt E-Mail„
Fi I I I n fe e s i mple Title Ho Fier on next p a ge ( i
state *r CountV License lc�l' M
frorrti the L;wn er V V19:1
1f �� LU � of e�nSCru ck i art is ��ee o r n'+�re, � RECORDED�Ie of CaMm
enCeMent iS required.
If value of HAV is S7,50Dor rrore, a FtECO E ]a ice fCommencement required. —
SUPPLEMENTAL CONSTRUCTION LIEN LAW fN
' DESIGNER ENGINEER: Not Applicable �
Na rune r
Address.
iI State:
ZIP, Phone
FEE S1MPLE TrrLE HOLDER: Not Applicable
Name:
Address:
Cats{:_. _
ZiP: Phone:
'OR ATION:
M OIRTISAG E CO M PANY;
Applicable
Marne:
Add ress=
City: st-ate:
ZIP: Phone: A
BONDING COMPANY,
N a me;
Address.
i ;
Zip- Phone:
-I.
,i- Not Applicable
OWN ERI CONTRACTOR AF FID IT: AP PI i cati on is hereby mad a to obta i ri a permit to do th a work and installation as i ridicated.
I certify that no work or Installation has commenced prior to the issuance of a permft.
St. Lu cie Co u nty rn a k-es n o representati on that is gra n#i ng a Perm it M111 authorize the peem it hold or to b u i Id the 5u bject structure
which is in confIia with any applicable Dome Owners Ass+ociation rules, bylaws or and covenants that may. restrict or prohlbit such
structure _ please cans u I t with your Home Owners Association and nevi eve your deed for and+ restricHens which may apply_
In consideration of the'rantfng of this requested permiltr I do hereby agree that J will, in all respects, perform the work
in accordance with the approved plaits, the J=lorfda Building Codes and st. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency reWew; room additions,
-accessory Structures, swimming pools, fences, waft, signs, screen rooms and accessory uses to another non-residential Use
WAR N ING TO OWN E R.- lea u r fa it u re to Record a Notice Gf Commencern ent may result in Paying twice for
Improvements to vour property. A Notice of Commencement mu!5t be recorded in the public records of St,
Luce Coyrity and posted cn the jobsit�! before the first inspection. If you Intend to obtain finarrdng, consult
with lerr e r rM �ttorn befare commenci ng work or recording Year Notice of Commencernent.
Signature of Owner/ Lessee/Contractor as Agent for G wner
STATE OF FLORIDA
COUNTYOP
,5w rc to
or affirmed) a nd s u bscri bed befa rE me of
hWeal Prime ce or Online Notariz�tivn
this day of . 2021 by
V; rf4LX
NaMe of person making statement.
Personally Kncwn
Type of Eden ificalion
Produced
(Sfgna
5ignaturi� of -Con-tractor/License Holder
STATE OF FLORIDA
COUNTY OF f-
to (C r affirmed) and s u bsori bed before me crF
v�r rrr
hysioa l Presence or ON i ne Note rizatiori
this day -of 2026 by
Name of pe roc n maki rig state-merrt
OR Produced Iderrtificatfon Perscnally Known OR produced Iden ification
Type of Identification
Prod LFed
of Nota ry Vu bl et- State of Florid a
,�EK A L. F`RA�I
ComrtissiGn N
RENEWS
DATE
RECEIVED
DATE
CO PLETE D
ev.
Ey'py ,d,pcil2q.2G23
art } IadI'd :,0Lr� ServLm
FRONT ZONING SUPERVISOR
COUNTER REVI EW RVI EW
(Si ,atu re cf Notary PuN ic- State of FRarida )
rnmission Epic_ � ``` -, �
,IENNAL_ FRANCO
PLANS I VEGETA-FION
REV I EW REVIEW
11EKNosApciii 29,2023
SEA TURTLE MANGROVE
RElulEW REVIEW