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Home My WebLink AboutBUILDING PERMIT APPLICATIONPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO HE ACCEPTED I a;. Permit Number, � , N Pla `ping and Development Services eui, .. ing and Code Regulation Division 23gg Virginia Avenue, Fort Pierce FL 34982 PhOe: (772) 462-1553, Fax: (772) 462-1578 i PE,�MIT TYPE. � JbKq Address' Site Building Permit Application Commercial Residential �/' rty -Fax ID #: � �__ 1 �!' � =' �� Lot No. r-J-7- Ian Name: �.11 JITIYI�L UI4Y, ! '2-- — Block Na.�' -t Name: Adt}`f'tional work to be performed under this permit -check all that apply: <' Mechanical _ Gas Tanis _ Gas Piping Shutters Electric J Plumbing � Sprinklers _ Generator Toth! Sq. F` of ConWLA::tion: _w �3�. ^_ Sq. Ft. of First. Floor: Cos , of Construction: $ �' , �� •_( ]) Utilities: —Sewer _Septic Wine` _ U State:t #� Code: _96, tax: -ne No, -76) in fee simple Title Bolder on. next page if different n the Owner listed above) Y-W indows/Doors Roof Pitch Building Height: Name: Company:.juf� ' MSG 1 eUtcrdl tk �eifS�ctv_( u Address; 110 13 Totha.kQ kl ©0 Ue I^ City: �(ka+_ i",e- —Stater Zip Code: 3MV7 fax: 3ai-3�v_ Phone No -77'a1--3 7- E-Mail9L#Ar State or County License f' If v4fue of construction is $2500 or more, a RECORDED Notice of Commencement is required. If value of HVAC is. �7,54o or more, a RECORDED Notice of Commencement is required. I ress: Not Applicable State: ZiPV—__...-..__. --- Phone ...--�. FFF SIMPLE TITLE HOLDER: . Not Applicable Address, cjty: Zip.;` Phone: MORTGAGE COMPANY: Name: Address: City: Zip:.--,--_— Phone: Not Applicable State: BONDING COMPANY: _Not Applicable Name: Address; City: Zip: Phone:. V!fl ER/ CONTRACTOR, AFFIDVIT: Application is hereby made to 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. A. vnakes no representation that is granting a permit will aulhori?e the permit holder to build the subject structure 1hich is in conflict with any applicabie Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such truc: vre. PiFas� cons ult w. th your Home Owners Association and review your deed for any restrictions which may apply. n cchsideration of the granting of this requested permit, I do hereby agree that I will, in ali respects, perform the work n acOrdance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. he fgllawing building permit applications are exempt from undergoing a full concurrency review: room additions, E . structuren, sw'.rnming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use `WAANItNG TO OWNER: YOUR FAILURE TO RECORD A NOTICE Of COMMENCEMENT MAY RESULT IN YOUR PAYING '�W.p--E FOR SMPROVEMENTS TO YOUR PROPERTY. A NOTISE OF COMMENCEMENT MUST BE RECORDED AND P015I ED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT 4Vt i YOUR iLENOER OR AN Afil'ORNiEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Iri Signature of Owner/ Lessee/Contractor as Agent for Owner STATE C F Ft.CDML;A CC,4J1 'CITY GV - ..._....-------- ---- --- Th' ;`�fargoin was acRriowieojged ; &Ore me this; day of_ , 20_ by person rnaking statement. Per, �n8;v Known OR Produced Mentif€cation type' ot„idenrflcatic, (Sig idturrel of Notary Pulbilc= State of Florida ) co", rnission No. (Seal) Siena ure of ContractorJLi ease Holder STATLCOUNTY (�F FLC3MA� �1�IaIdaYOF rile 1nr ing instrument was acknowledged before me this day of}pfkG,t!�j2o2ir by Name of person making statement. Personally Known. �� OR Produced identification - r'ype of identification P;t}luced__„—. - re of(NAtary Public -State of Florida ) Commission No�4 (SUNkEYK NdTONEW MY COMMISSION # HH 14361 ..N-....,..._-.�...._�»--....�.w.�—.�^ REVIEWS FRONT I ZONING SUPERVISOR PLANS VEGETATION fFOi F4?:`�• W�wJrVl7llG M1lau •w COUNTER. REVIEW REVIEW REVIEW REVIEW REVIEW REVIEiN 1 UATII- RL-GElVr.E, p11T,.E COY.PLFlE V.