HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Orocvo`� O J ITS
Date: 2 -Z Z ,7 d Z2 Permit Number:
- FEB
Building Permit Application
St. Loeb t;;�3Nf icy
Planning and Development Services Pe- TM1 l
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 -Cerro im rcial Residential
PERMITTYPE: VvI(JI,O - ,zJ-14- 11L- fle(LoqfVQ -
Address: A I U 5 r V . it >i title- IV t/U
04fProperty Tax ID #: 2 /► "" 7 �Lot No.
Site Plan Name: r" ►+C;r(; " R6 — GAS 7`Z a A/yo Block No.
Project Name:' A?03 , uN lT .
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters 0 Windows/Doors
Electric — Plumbing _Sprinklers _Generator' Roof' Pitch
Total Sq. Ft of Construction: ,--� -- - -Sq. Ft. of First Floor:
Cost of Construction: $ .!261Jy, tSL.,., Utilities: —Sewer _Septic Building Height:
Name
rE
Address: :9 ! O 1 M- !2
State: l;
Zip,Cod�: �., Fax: =`3.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:yi� �'►1a41�-S�FA;Cc: .
Company:,.I V J L�. IV-XAAJS -A
Address: J fJ. 'i c-h44-i✓o.o:9 OIL-
City: P A i- -- 6A--i `State: P Z.
Zip Code: 3 ZZ4o4 Fax:
Phone No 4S-t-3' '1
E-Mail dr, % 2 @ !4Tr , Svc;-%
State or County License C-C r- OS"T"I t fj
it value of construction is SZ5UU 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.
11
14
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone: -
BONDING COMPANY:
Name:_
Address:
City:_
Zip:
Phone:
Not Applicable
State:
Not Applicable
OWNER j CONTRACTO R-AFFIDIT: Application -as hereby -made te-obtair-a,permitto do-the_w orlcand_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 p&rnit; I do hereby agree that'l 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 concurrericy review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another nonrresidential 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
`W1TH YOUR LENDER 9p,AN ATTORNEY BEFORE RECORDING YOUR 1,90 ICE OF CO MENCEMENT."
natu a Ow r/ Les ee Contr or as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA jj
VI.L LC
STATE OF FLORIDA
COUNTY OF LI G1Y,
COUNTY OF
�
The forgoing instrLrent was acknowledged efore me
The forgoing instrumpat was acknowledged before me
this ���T" day of f z�i�w� '•. 20��•by
this _�O day of U-r�#e- 20 Zby
Name of person making state ntent.
Name of person making statement.
Personally Known OR Produced Identification
Personally Know n•OR Produced Identification
Type of Identii:itation
p%,it<i
Type of Identification
Produced
Produced
(Signature o otary Pu If "`of Frbridssjon k GG 207106
`- (Signature•of. No y P bii. State' f I ri
My Comm. Expires Jun 12, 2022
Commission No.� Iz Z
==ISi DI�NE.MARSHAII
State of Florida
Commission No. �0 !
''
My.Comm..z:i•• ,a• 19.2025
®O'Iced :lrOL sa^ara; Nctar: assn.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
-
DATE
COMPLETED
Rev. 2/7/19