HomeMy WebLinkAboutApplicationAII APPLICABLE INFO MUST BE COMPTETED FOR APPLICATION TO BE ACCEPTED
Date:/o.of, #
720/'37t-22 I
Permit Number:
S,'r" Ltt-crt-l
L.Building Permit Application
Planning ond Development Seruices
Building and Code Regulotion Division
2i00 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-t553 Fax: (7721 462-L578
Commercial Residential
Address:
Property
8 f€a Bu 3?75 7
Tax lD #:qr/t- t/0 - o 071- 000"0 tottto./d
V;n Block No.Site Plan Name:
Project Name
/7? e
v? l,1r?,
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION I NFORMATION
Additional work to be performed under this permit * check all that apply:
-Mechanical -
Gas Tank
-
Gas Piping
-
Shutters
-
Electric
-
Plumbing
-
Sprinklers
-
Generator -
Windows/Doors
-
Pond
_ Roof
-
Pitch
7{7 Sq. Ft. of First Floor:
Cost of Construction: $hoo..,Utilities:{S**$ -septic Building Height: YfT
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.
PERMIT APPLICATION FOR:frr*o f ; f;on
PROPOSED IMPROVEMENT LOCATION :
4il1 flr
4rt oo-*,v,t
OWNER/LESSEE:CONTRACTOR:
Name 40
Address:t.Dr.
City:State: FL
Zip Code:Fax:
Phone N E-
Mail:
Fill in fee simple Title Holder on next page (if different
from the Orrner listed above)
Name
Company:
Address:
I fr.
/,e. f,ocur. fl
City:<W State: FZ
zip code: 3 lffZ rax: 772-2V 2 -2/ El
I phone tto 7 7t
E-Mail
State or County License
4rr7
c:gc /2 7a/
/ 0- /v-21
Llrli
X
CBDG Funding
Total Sq. Ft of Construction:7/7
DETAILED DESCRIPTION OF WORK:
Na
StatdCity:
Zip: _Phone
Address:
Name:
_ Not Applicable
Phone:
StateCity:
ress:
FEE SIMPLE TITTE
Name:
Address:
City
zip:one:
Not Applicable _Not Applicable
Phone:
Address:
City
Zip:
BONDING
Name:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indi
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is erantins a permit will authorize the oermit holder to build the subiect structure
which conflicts with anv applicable Homeownerslssocia-tioh rules, bvlaws or and covenants that mav restrict or orirhibit such
structure. Please consult With your Homeowners Association and ieview your deed for any restrictions which may apply.
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 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: Yourfailure 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 and posted on the ite before the first inspection. lf you intend to obtain financing, consult
lender o n attorn nc work r I ur Notice of Com ent.I4)re E
as Agent for Owner
STATE OF FLORIDA, / ^ l, /
COUNTY OF //,i&-N M
l{,y 6hVsical Presence or
-
Online Notarization
Name of person making statement.
Perso Known _ OR Produced V'
Produ L.
ry Public- State of Florida)
commission *r. bb I 1p4 Ntls""rl ^.gfl'/ rtrg
+! r'. / ir" il\s.. z1
,Hg*+
"IESSE DOSS
Conrmissicn # GG 26306$
Expircs fje phrmber 27,2422
Uoad0rl i liru [turlir-{ Nltary Seillcer
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
CONSTRUCTION LIEN LAW INFORMATION: