HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST'BIS,-,-.;46qPLETED FOR Art-Lit-
Date:Ap
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34932
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE: S �—t
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Site Plan Name:
Project Name:
TION TO BE ACCEP
Permit Number:
RECEIVED
Building Permit Application MAY 1,8 2021
Permitting Depei`Wft
St. Lucie Cwtiify
Commercial Residential _z_
Lot No.
Block No.
Additional work to be performed under this permit - check all that apply:
Shutters Windows/Doors
_Mechanical _ Gas Tank Gas Piping _ — ��--�_
Sprinklers Generator Rod'�f � th
Electric _Plumbing — P —
K�ota4 q ,f�C«o:�struction: ��% S T Sq. Ft. of First Floor
C��21- utilities: � ''e trc Buildmg Height
Name 1T1-3niAC l is $ M 1CI
Address:Z!9 7 3 4,h e Ix ( t0 01
City: F.. k P i�P rc t- State:
Zip Code:-3!1927- Fax:
Phone No. mg. 3 u ,-RC g®
E-Mail: -? Yvva e zM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above) '
Name:
Company.
Address: ,
Zip Code: Fax:
Phone No
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.
State:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: — Not Applicable
Name:
Name:
Address:
Address:
Citi.- State:
y
Zip: Phone
City: State:
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
swhich tructure. Pleain secc coth nsult w with applicablemay a. prohibit such
lome Owners Associationtion andrreview'your deed or any rbylaws or and oe trts i t o s hat whichrestrict
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."
I
/
I,
ignature of Ow er/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF SAr.
STATE OF FLORIDA
COUNTY OF
The for oing instrument was acknowledged before me
this day of I'N" , 20'8.1 by
The forgoing instrument was acknowledged before me
this _ day of 20_ by
,np"1 6bc CAS
_
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
Personally Known OR Produced Identification
Type of Identification
Produced
cS
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
(Signature of Notar ate v e of Flgu I J ate01 `
Pv°t`ommisswr' 4 s jan 28' 2025
Commission No.O= MY Commh�N�Ioraltj tary Assn'
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0° F`gonded OrOr
REVIEWS FRONT ZONING SUPERVISOR PLANS I VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW I REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.