HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
LU L
L L` L L y Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: .fie V-Ctey Car O-eS
PROPOSED IMPROVEMENT LOCATION:
Address: 31 1 4g E'd " f J S RGec�
Property Tax ID #: ' 1 A3 - b00/ - 3 50 - G Lot No.
Site Plan Name: Block No,
Project Name:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical
Electric
Gas Tank
Plumbing
Total Sq. Ft of Construction: Y A -
Cost of Construction: $ L 7Q0 0
(Affidavit required)
_ Gas Piping _ Shutters Windows/Doors Pond
Sprinklers _ Generator Roof Pitch
Sq. Ft. of First Floor: Nl ft-
Utilities: _ Sewer _Septic Building Height:
OWNER/LESSEE: I CONTRACTOR:
Name J Vr 1--Q L' Gt r A -c 5 I Name: 4, 1 (A) h it A h6L Yn
Address: 3 irg o I b J Company:&L)4_ P/n, c h lum• lYJ�
City: I,94C 2 State: JL Address: y$D? 05 /1WY l
Zip Code: Fax: City: State:
Phone No. 7 %o) - g gad — C] S; y _ E- Zip Code: f� Fax:7 ;9' 1-1 r4- 1D 7V
Mail: S Q 1�-VVI Q VVI Phone No 7 7d' EGG- Oct/ 3
Fill in fee simple Title Holder on next page (if different E-MaV SF o PR6099 54;tw 7m• coyy-'
from the Owner listed above) State or County Licensefi_;RG 1330 7/ ,--,',
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.
SUPPLEMENTAL CC
DESIGNER/E GINEER:
Name:
Address: S 0 a.
City: wrn P
Zip: _31a.0 el W
FEE SIMPLE TIT HOL ER:
Name:
Address:
City:
Zip: Phone:
LAV I INFORMATION.
5plicable
State: _ -,
x Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: x Not Applicable
Name.
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made tc obtain 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 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 prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions 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,
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 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 NI7_T�!-.OBTAIN FINANCING, CONSULT
WITH Tgi1 NDER OR AN ATTORNEY BEFORE RECORDING YOUR•NOT OF COMMENCEMENT."
Signature ner Lessee/Contractor as Agent for Owner
Si 'g'R e f Icense Holder
L1
STATE'OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST LUCIE
COUNTY OF ST LuciE
The fogwing instr ment was acknowledged before me
this IU"^day of 20�
The foroing instrument was acknowledged before me
by
this16— day of P14/y 2014 by
GARY WHIGHAM
GARY WHIGHAM
Name of person making statement.
Name of person making statement -
Personally Known X OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
�& I A /' d'eL2��s
Produced
—
(Signature of N
(Signature of
id' 0611�1 Notary Public State of Florida
Commission No, Emily N Hicks(Sealmissiojj
Notary Public Stele 01 Fknda
Commission N Emily N Hicks
8130/2t 24 03754 t
p, w Expires 08l30/2024
► "Sion HH 037541
a, * Expires 05/30/2024
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
o.,