HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ifs IZ5_Z i Permit Number:
Building Permit Application
Planning and Development Services
Building and code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
Residential I/
PERMIT APPLICATION FOR. G PA Lem%cce—.
PRQP{�SEt�}11i1PR0�iE111iEN� �a�ATON; _
Address: (0 FA L..0 A, 1-4-0 L_ t)
Property Tax !D 000 Lot No,
Site Plan Name: Block No.
Project Name:
t
TAILEDr, 3l_SCR P_T101 OF WORK. `
12� t e- _ t 5- rV Le)ta:#�-Vt r 1 ��-
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATIQN:
Additional work to be performed under this permit- check all that apply:
_Mechanical — Gas Tank _ Gas Piping _ Shutters Windows/Doors _ Pond
_Electric V Plumbing _Sprinklers ^ Generator _ Roof Pitch
Total Sq. Ft of Construction:: Sq. Ft. of First Floor:
Cost of Construction: 1 n&5 f
)C 7r Utilities: —Sewer _ Septic Building Height: _
--QWN ER/LESSEE:
CNTRACTR:
Name Tem I p�,� (i�
Address: Aci+o
Name: M Ptf�'-t � i� �C���i�✓
Company:,
City: _ac t 'si 1 �1� - State: F- -
Zip Code: 3q q'y ., Fax:
Phone No. 31- -
Address: i a 37—
City: 41 Lv"e State: ALL
Zip Code: -3� Fax:
Phone No
E-Mail YYIQar p i 2 e neQtc i��rye�
State or County License CFC i `4a! 9 4 35'
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
If value of construction is ZSnn nr mnra = RFrnRnrn n;..+; ..c.-
is required.
If value of HAVC is $7,50p or more, a RECORDED Notice of Commencement is required.
���.v��� zay�rnlrttt: Not Applicable
Name- _
"Address:
City: State:
zip:. Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address: -
city:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: —Not Applicable
Name:
Address:
city:
Zip: Phone:
OWNER/ CONTRACTOR AFFMIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
1-certify that no work or installation has commenced prior to the issuance of -a permit
St.1_ucie Coun{�, 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 Howie Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Horne Owners Association and review your deed for any restrictions which may apply.
In consideration of the ti f +'
gran ng o is 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 Comrnencernent
improvements to your propertyor
. A Notice of Commencement must be rrecmay orded 'iIt inipnathe p li ce €records of St
Lucie County and posted on th Jobsite before the first inspection. If you lend to obtain financing, consult
wit Fylfen cl�er or an attorney bef, a commencing work or recording Atni it Ki, .tea A
of Owner/ Lessee ntractor as Agent for Owner
STATE OF FLORIDA 3
COUNTY OF 5'� Lk c: i c-,
SWVFi to (or affirmed) and subscribed before me of
V _Physical Presence or Online Notarization
this Z, clay of C--+G -•j 2020 by
Narrle of person making statement
Personally Known J OR Produced identification
Type of Identification
Produced
(signature of Notary
Commission No.
STATE OF FLORIDA
COUNTY OV 'S'T %� Cc <
sworn to (or affirmed) and subscribed before me of
_P/ Physical Presence or Online Notarization
this Lday of � ' 2020 by
Name of person making statement
Personally Known OR Produced Ident icatioii
Type of Identification
Eb
E c(Signature of Notary Public State of 3 0irinwr cotKota State of Florida - _ Notary Pubik - Stat o iorida
# GG 4610ag Commission No. caminissi a # GG n
MY Comres Mar 14, 2024 My Cflracm. Expires r .202,
onal N Assn. _ "Harmed tt+rough National of Asss
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