HomeMy WebLinkAboutBuilding Permmit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �r1
Dat�•P• 2' Permit Number Dy 7
RECEIVED
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE:
Building Permit Application JUL 0 2 2021
fit, Lucie County
Permitting
Commercial Residential
Address: 2 L)l :h orih 3 S4-reef 2'Forf Tt&cel. V-I. 3g917
Property Tax ID #: 04 V D - � 03 - Qi Q- 0 c) 0 -J Lot No.
Site Plan Name: Block No.
Additional work to be performed under this permit - check all that apply:
—Mechanical — Gas Tank — Gas Piping —Shutters _ Windows/Doors
— Electric — Plumbing _ Sprinklers Generator _ Roof Pitch
Total Sq. Ft of Construction: ^I U O Sq. Ft. of First Floor:
q;t..of,GocStruc,.tian:> 0l_/0 Utilities: —Sewer _Septic Building Height:
}� t 4'
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Name Ze.Kle 0.(1'f'
Address: ='(Lewot—T'1
Company:
City: Fo r'Re-rcz State: 1=
Zip Code: 3 (4 q 4 % Fax:
Phone No. -1 - '5a 3` a0(f a 3-.
Address:
City: State:
Code: Fax:
hone No
E-Mail:
Fill in fee simple Title Holder on next page Yif different
from the Owner listed above)
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.
0
DESIGNE
Name:_
Address:
City:
Zip:
FEE SIMI
Name:_
Address:
City:_
Zip:
GINEER _Not Applicable MORTGAGE COMPANY: — Not.Appkcab-le
Name:
Phone_
ts-T. HOLDER:
Phone:
State:
Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Aririrp-q
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit Lo ao Lne wurrc drru 111JLd dL Vi
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
which is in conflict with, any applicable Home Owners Association rules, bylaws'or'and covenants that may restrict or pprohibit such
structure. Please consult wm
with your Hoe Owners Association and review your deed for any restrictions which ma -apI. .
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 toanother 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
v,..n .ew -n�s�r■r^tr ,fere ,rn�f�C611R^CMtFMIr fl .
WITIFI YUUM SLIM K AN AN I WK1%rL ■ m■-e %OM- ■ia a v■...
-- --- -- — —
ASignr
O r/ Le e/Contractor as Agent for Owner
Sign of Contrac or/Li se Ho d
STATE OF FLORIDA, � /� p'
`
STATE OF FLORI[ft
� �C�
COUNTY OF t3cY' l� MILD lr WN�
COUNTY OF
The fo of g instru ent-vas acknowledg before me
21 by
The f oing instru et as acknowledge efore me
this ay of 20 by
this of
F R
Name of person making sta me t.
Name of person making statement.
Identification
Personally Known OR Produced Identification
Personally Known v' OR Produced
Type of Identification
Type of Identification
Produced
P o """"-•., SIERRANICOLEDENIS
Notary Public - State of Flo
;,•t LY •. SIERRA NICOL
a°�� • Notary Public -Sta
DENIS
eof Floria Commission GG 11A6e
My'Comm, Expires Jul 26. 2
• : Commission 9 G
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(Signature of Notary Public- State of r r ' ,.••' BondedtNougl'Sabo
r IN6 ONotary;Public Stat *A Ili
Commission No. `, i a (Seal)
Commission No 1� (Seal)
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