HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI
AIIAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date 8 ld'2t
f acrf, *Permit Nurnber:
q27-37t-{qt
Building Permit Application
Flanning and Development Services
Building and Code Regulation Division
2300 Virginio Avenue, Fort Pierce FL j4982
Phone: (772) 462-1553 Fax: (772)r 462-1578
Commercial Residential X
PERMIT APPLICATION FOR:D"ro /; f; o ,t
PROPOSED I M PROVEM E NT LOCATION :
Add ress bLl fl/c ll/e s P/"J. I€nren 3*,o/,trL. 3/7 ,7
Property Tax lD #:
Site Plan Name:
/ro2- ,0/- o/20- ooo- t rct Na. 27/
lrrfi/u Tr/o" y'
Project Name 23 "/
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n C ,tr)ur h-q
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 _ Plumbing _ Sprinklers _ Generator
WindowsfDoors
Roof
Pond
Pitch
Total Sq. Ft of Construction Sq. Ft. of First Floor:/rt"/
Cost of Construction: $/?00.,,Utilities: XS"*ur -
Septic Building Height:ffr
lf value of construction is 2500 or more, a RECORDED Notice of Commencement is required
lf value of HAVC is 57,500 or more, a RECORDED Notice of Commencement is required.
DETAILED DESCRIPTION OF WORK:
OWNER/LESSEE:CONTRACTOR:
Name
Addre SS:
City o State: t/
7r/q 6 7 Fax:
PhoneNo. 8/3-80/- d,33
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed abovel coc lz,fgl Pt
Name
Company
Address: /6/ zlfa fuerc.. tl
City frrsc, Bcor'l State tu
zip code:3/7f7 Fax:77)'232-2/?/
Phone No
. <0mE-Mai ar,t/t2 t , t|C
State or County License
LUCIE
Block No.
,{c/tl
Zip Code:
State
Name
Zip
City:
Phone
DESTGNER/ENGTNEER:
Address:
Phone
ate
leMORTGAGE COMPANY:
Name
Address:
City:
FEE SIMPLE TITLE HOLDER: Not
Address
neZip:
[\ame
City:
_Not ApplicableMPANY:
Phone
Address:
BONDI
Name
City
zip:
CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and lation as indicated.
that no work or installation has commenced prior to the issuance of a permit.
such
ly.
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 foilowing building permit applications are exempt from undergoing a full concurrency reviewl 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 paying twice for
improvements to your property, A Notice of Commencement must be recorded in the public records of St.
Lucie County a
with Iender or
nd posted on the jobsite before the first inspection. lf you intend to obtain fi cing, consult
atto be menct work or recordi rN of nt
Sworn to {or affirmed) and subscribed before me ofl/ Phvstcal Presence or Online Notarization
'n;t )k- "v or fl*qwf ,2029 by
rtdo- *^ 4
Name of person making statement.
Personally Known OR Froduced ldentificationi,,:;:JiSW.
/--- €tw Aie_*1- -
$ienffr
**Commlsslon # GG 263069
6Qn&b sePtemu er 27, 2022
Bondod Thru Budg6t Not8ry Softlces
Owner
Conrrnissiqn No.
Notary Public-
as Agent for Owner
) tessrooss
COUNTY OF
STATE OF
Name of person making statement.
. nu'-
Personally Known OR Produced ldentification l< _
Holder
Sm;14,.
ott,rrt
>rt
*
Bondod Thru BudgotNotary SoNIc€8OF
*Commlsslon # GG 263069
($md beptemua r 27 ,2022
or
) and subscribed before me of
0niine Notarization
2A2o by
Signatu
Commission No.
Notary Public-) lessr ooss
Type of I
STATE OF FLORI
COUNTY OF
Ad"^
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
SUPPLEM ON LIEN LAW INFORMATION:
to build the
may