HomeMy WebLinkAboutBuilding Permit Application r �
Ali'APPLICABLI NFO MUST BE COMPLETED FOR.APPLICATION 70 BE ACCEPTED
Date: -Perinli Number:
Lfi L
FL
Building Permit Application
Plannrng.and tleveloprnentServlce-
euilding ohd.Code Reguldtiod Division Commercial -Residential
2-9dO.VFrginrb°Aveaiie,Fort Pierce:FL 3.4982
Pitoriei{7. 2)462-1553 Fax:,(772)462`1: 7.8
PERMIT A puc-ATI.QN.,I O.k:
.P.RO.POS >:Iit/IPROVEiVI:tiIVT:LOCATIO:N:: - �
Address:
Property Tait 1D it `~ �U � -3 Lot No. (Of
Site Plan Name: Q&AAL N
C Block No. i
Project Name: �� S
DE'TAIi ED'.DE'SCRlP1`f,ON::OF tlV -,Rtt:: 7.
. ., �.
Wo iC
New Electrical Meter Second Electrical(Meter
CONS TRUCTi.0.1V:1 N.>'QFt1UlATkflN::
:.:.:: . ..:..:. .. . . .:.:......r...:..:
Additionalworktabe-peif—wrned under this-permit-checkal[that apply:
_Mechanical Gas Tank Gas-pipit) .Shutters _'Windows/Doors _Pond:
Electrit Y Plumbing -Sprinklers Generator Root. Pitch
_TctaI Sq..Ft bf:Cbnst ug. ian.� -•-"'(�l_J. ��n _;.,s�Sq`F,t�t3f.l irs�Floor`
` Cosf'zsf Construction $ cJ� d/ Q Utilities: _Sewer Septic•r B•uiidint Height':'
0•ER_LESS:EE M.—
AS CONTRAGTI].R: :....`.
'�' = - - _
I M ME Narne:. Y
Address•.��1 � Gompariy:. '� '
y city; _�f?Y� - 1 ram.- ,c� 5ttste:� ` Address: 5 Z
Zip Coder.'j Fax_G�v r � ii city t7� State:.
Phdne.No:. Zip(ode- _ Fax:
E-Mail Y r- !! Phone' No. f -
Filifn fee:s1Mp[eT le Heider da next page{[f d[fferent. E-Mail ` t5.
from the Owner listed above) _ Y 5tateorCounty icense C 12531��
If U3iue Of construction is 2500 or more,.a RECORDED Notice of Commencement is required.
If.Value.of HAVC'is$7,500.or.More,a•RECORDED-Motice of Commbncemerit wrequired,
F
a N.
`L•�:- - �� CTE•• .L E .:LE1W�.IN RM f0
S�•�.`U 01V:Pf. Ni�EN P
DESIGNERANGINEER: MotApplicalsle MORTGAGE MPANY: �dtApplicable.
Name• [Name:
Address; Address:
City: State: City: . State:.
Zip: Phone Phone:.
FEE 5(MPtE TITLE 141BER:, Not;Applicable BOND G.:COMP.'ANY' Not,4pplicable
> Name: Name:
Address: Addrass.
City, City:
Ztp: P hone: zip:. one:
OWNER/CONT3taCTOR AIPPI NIT:Application is'hereby made to obtairt a.-permit to do the-wbrk•arld installation as lridicatgd..
I Certify that no wj ric.or installation has commenced-prlor to the Usuance.of a permit.
St..Lucie countyY makes no representation.thatis granting'a permit-will au�},odie the permit holder to.build the subject:Aructure
ch is in-contlictwith any applicable'Hortie.QWnersAsst)ci2tion rules,bylaw.s.or and covenarits:that.rtiayrestrict or-prohibitsuch
structure.Please,consult with your.Home OWriers Assbciathin and,revlewyour.deed f&ainyrestricticins whichmay.apply.
.in consideration of'the grailting•af thisrequeAgd.permit,I'do hereby agree That I.vvlII,.in all respects;perform-the'•irvork
in accordance with tihe.appo.ved plans,-the'Floiida 9uilding Codes.and•St.Lucie County Amendments:
The folloWng building permit applications:are;exerrptfrdm.undergoing a fall concurrency review:room additions,
accessory structures,.sWii7iming':po'ols,fences,.walls,signs,screei3 rooms,and accessory uses to another non es identfal:use.
WARNING,TO OWNER:Your failure to Record a Notfceof Corriinencerhent inay result in paying twice for,
improvertients to your propel ty,A Notice of Gomni n�cernent must be recorded in the public.records cif-St
Lucie County and posted on the jobsite before the first iitspectibn. If ydu.interrd to obtain financing,consult
with lender or-an attari�ey before carrtri3encPrl�vvo;rEc`.or recording.your Notice of Commencement.
_ i-
`` ;Sig a,u.e af.;OtFri.'::[esse .ConiractoiCasA eltfOcOwtle 1 Signature o'Con actor rise Holder
STATE OF FLORID" f I STATE OF FLORIDA
I
coun>6F• J{ L.td.( i COUNT-roF.
Sw_o tq(or of€irmea).and subscribed before me of i Sworif.to(dr affirmed)and subscribed_before me of
Physical Pre en r Online fvotarfzatior �? 'hysical Presence or online Notarizatioh
I this '.day.of 203 by this dayof•' y,
Name of person making.statement: Name f e• orrmaki. statement.
Personally ICgoWn OR Pro en Berger I Persarially Knotvn -OR.Produced identification
Type of identification NO'FAFtY:PUBi.ICt Type of"Identification _ y :....Cassidy Berger
.Produced_ -+STATE OF FIbAroduced t D10TARY PUBLIC
Comrr#:GG973629 �STAT£OF FLORID
k.
2 -'� Comm#GG973629
(Signature of N :Public- a of'Fiorida l (5i nature of Notar. Puh'c-Sta �idi�XpiCes 312612a24
"
Commission jqo.- (Seal) 1 commission No. (Seal)
REVIEWS- j• FRONT ZONING :SUPERVISOR �PCANS VEGETAT{ON SEA`fURTCE TtIAIVGfiOUE.
COUNTER RE-VIEW REVIEW j REVIEW REVIEW' REVIEW REVIEW
DATE 2
RECEIVED
DATE- ,
COMPLETED I