HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All, LICABLE INFO MUST.BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:.' aA�iZ- Permit Number:. � ��
JAN 6 Z02Z
Building Permit Application St.LucleCoun
Planning and DevelapmentServices
Permitti
Suilding.and Code Regulation Division Commercial Residential
2300 Virginia.Avenue,Fort Pierce FL 34982
Phone: (772).462-1553 Fax: (772)462-1578
PERMIT APPU CATION FOR:
�' s�. -<-.�^t'�..i`:' -1=� +c^.'�e.,�..a,, r-:S�tv«.z._J,' 4�5.,£ •j- ��,..���a�_Ya_ V.'t,.:v �-s .s� �:�.�-,-,�'.�"``N'e��_ s fin..
Address:_Z�0 7 l V, ��1/!�� �1.� :(�� l�� ! jZ�21 i 1-�:�--�� ,��9��T .•
Property Tax 1D#: l��.s� 7p�- �1.b7 -- �3 0�0 Lot No.
Site Plan Name: GcP .I.-C-Ode 8tAell S�GTJ orJ C)P)g Block No. 7
Project Name: �� r
��].r• a m.. �r�j^^��} �3�z����'_-r ''�k :���ra�'us 2 �i",����fi ,� a�.`-'.r Fza. "�.-i•,•vnb y-.�-zr '��� �=;�-��-"�-'j`��-�'gT,t,,.pfi._ -'�.
a•%��,��-�i� ir�R��� �� �',-. .: ��'�'v. s r flk' T��;.sz:.er $. 'v a �la. c wr-•�"t^�,.,.i���'a s�`�+•ro�.���}�t'4�"',"Sd� �,3},7`y,,��r��
T
C.M- ,.. '...:.5.-� fs ,. ..fir-_rf.".','+„H`at-, ..7-;..,.�..,�•-__r-3,.._��1..-,�r.,._r`�.r.,.,-.•+r.� ��"h�siw-,3v?•$`a�._..__�__.....:.. h..,_l x._�:...+I. ''a;^ ,..:�-.c..�-;
r, to
w u/w
New electrical Meter Second Electrical Meter
�►re �j �,[� a c a. '�.�..t �'+ r�r '..'4,r ,��', ^s:�'`�i ''� �� si�s,t^ x` �f� 9�;u��=1s
Additional work to be performed under this permit—ch-eck all that apply:
_Mechanical _Gas Tank _Gas Piping i Shutters _Windows/Doors _Pond
Electric —Plumbing —Sprinklers `Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $_ ��j�0 a� Utilities: _Sewer _Septic Building Height:
x ;d4` p. �.^F E C'lt�`�. t4'�"`,,,x,"•-i^:»..` c _ 2 .-t�..,�a r 3�^,..�,. r'S/'':^.�.�*.a'm(',{�s�t,�,-fau u �*}r°° 2-:� '-e r, '� s*, 'S'i 7 �h�`-� '^t �.e �--t
.��.tfieAt`r.-'�s �s!_: �.'a r e�n`z h�.Te .-.:�'"Lr � �f'?E�' .�� :� ^4.'�tit �
:w... :k.,._°:.;:.: :-.�.a_....;ti_C^nl....,s :_'^.....su'•;.", 4*i'.k.!iR'ei _,-.,....ti.� 8r'.ale..,.,:::ti `' __*'+ .fi,+u" .,.d:�.-b....a�i:.�=+a:�_"s..
Nam.e•, :./ {,: �.FCI :.A1'/n�2_ N.atx�e.: V:l *t7: fns�n
Adoress:2 7Q 7 rX;V-r,A1�✓Y,;M1 t O/1 I � j Company:JAr✓t`A ',:jx4A.,s wt u (, e. l /M4
State:F1 '- Address 24 Ca T. t o i L*;n kod
ZipCode,: State: ?�
!"' ✓ t
Phone No. Zip Code: D;ZR a g Fax:
E-Mail: C-1463�'1Vt4r,_cD, our1-L-r_-�> c-o Phone No q;N- 6 o 5r• 3 5 $ 1
Fill in fee simple Title Holder on next page (if different E-Mail d ;%; Z @ A i'T, &�,t
from the Owner listed above) State or County License G 4c. -o S 9 `= l ft
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
'If value of HAVC is$7,500 or more,.a RECORDED Notice of Commencement is required.
WNW
0!
. ot Applicable N MORTGAGE COMPANY: NotAppficabe
Name ' --.
Name:
Address: Address:
City: State: City: State
Zip: Phone Zlp: 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 obtaid.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 hoiden to build the'subject structure'
which is in conflict with any applicable Home Owners Association rules,bylaws or and.covenants that may restrict or prohibit such
structure.Please consultwith.your Home Owners Association and review your deed for any restrictio,ns which may apply.
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,
1.accessory structures,swimming pools,fences,wails,signs,screen rooms and.accessary;use's to arother_non-residential use
WARNING TO OWNER:Yourfailure to Record a.Notice of Commencement may reWltJn.paying twice,for
improvements to'ypurproperty A-Notice of'Commencement must be recorded.in the Public records of.St..
Lucie County an osted:on the iobsite:before the first inspection.if you,intend to obtain financing, consult
with lender or . n ttotne before cdtmmencin work or'recordin : ourrNotice of Commencement.
Signature of 0, Lessee/Contractor as Agent for Owner 4 { Signature of Contractor/License,Holder:.
STATE OF FLORIDA' STATE OF FLORIDA
COUNTY OF �� LUG(f COUNTY OF St C uc
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization ' Physical Presence or Online Notarization
this 1 `f day of IAOy 20--D\ by this 14 day of 14 ,20 9A by'
Name of person making statement.. Narrle of person making statement,
Personally Known OR Produced identification Personally Known OR Produced Identification
Type of Identification Type of Identification ;
Prod ed Produced
(Signature of Notary Publ' rid (Signature of Notary Rublic-State of Florida)
SEVERLY DIANE MARSHALL a
}, °Ga . ay at BEVERLY �RSHALI
Commission No. �'fF Ut�' i -r: No 6 ic.=State or Florida Commission No ti
Notary Pub a of Florida
o: Commissio 4 HH 082192 '`��',,,���,c= Commission#HH 082192
'`•.,•oFrti°P' 'my Comm.Expires Jar.19,2025 :?o '� ' M Com
Notary As rr. Bonded through Nation i Notary Assn:
REVIEWS,.- FRONT ZONING= .:SUPERVISOR PLANS' VEGETA VE
COU}NTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW.
DATE
RECEIVED
DATE
COMPLETE D
ev.