HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLrYrD FOR APPLICATION TO.BE ACCEPTED
Date: Permit Number:
SCANNED
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Building Permit AppliPR 1 2018
Planning and Development Services
Building and Code Regulation Division ng Department
2300 Virginia Avenue, Fort Pierce FL 34982 y
FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial �l � � t � —
PERMIT APPLICATION FOR: �QdcvY, w �%Afh
PROP��'ED INPROVEMENT LOCATION:
Address: � (, (Q �ri�rs'I`T- (ui7 j Q 2,* E I SLICE :.3 Z/ 1�� " Z 5� 6
Legal Description: /�tj/��Y ;F��/��', /
Property Tax ID 4: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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onal worK to oe pe
_Mechanical
Electric
unoer
_ Gas Tank
_ Plumbing
s permit — cnecK a
_ Gas Piping
_ Sprinklers
a
Shutters
Generator
Windows/Doors
Roof Pitch
Total Sq. Ft of Construction: '' i' Sq. Ft. of First Floor:
1 �
Cost of Construction: $, ,� Utilities: —Sewer —Septic Building Height: 9
OWN ER/LE;SSEE:
C + NTRACTOR:
Name OAul p G/(/LI-_o
Name:
Address %4 Ce /
City: �U�7— l��ff2�� State: G
Zip Code: Fax:
Phone No. � `�L910
Company:
Address:
City: State:
Zip Code: Fax:
Phone No
E-Mail: ZALVIi � uoi, 0 iC1!�A
Fill in fee simple Title Holder on next page ( if 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.
SUPPLEMENTAL C .NSTRUMIflN LIEN A. OR
ARMT, ARRON:
DESIGNER/ENGINEER: _ Not Applicable)
-Name: P40Z.
MORTGAGE COMPANY: _ Not Applicable
-..Name:
Address:
Address: % O* �� 5 IY—
City: Po 0 - f ,:.57- ',LyC( c= State: _ L
Zip: Phone ZZ-Z 2'0r
I
-City: State:
Zip: Phone:
FEE SIM0dtITLE HOLDER: Not Applicable
Name:
Address: > I
City:. I
Zip: Phone: I
I
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ 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.
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
improvem is to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the st inspection. If you intend to obtain financing, consult with lender or an attorney before
commencine ork or recordine vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLO�IDA
STATE OF FLORIDA
COUNTY OF t-U c•� e
COUNTY OF
I
The forgoing instrument was acknowledge4 befohe me
The forgoing instrument was acknowledged before me
this \O day of Q A t `• 1 , 20 N by
this day of 20_ by
pay: �► c`-v 11 a
(Name of person acknowledging)
(Name of person acknowledging )
(Signature of Notary PubIQ- State -of Florida)
(Signature of Notary Public- State of Florida )
OR Produced Idenlific i
Personally Known at o
Personal) Known OR Produced Identification
Y
Type of Identification
Type of Identification
Produced I)EANNAMF�JEGNENs
• ? p �IIISSION # GG 022023
produced
=o;• my
-p becember 16, 2020
Commission No. '' . I EXPIRE�'�ubpcUndenvntere
Commission No. (Seal)
ondedThN .
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW --- -
-REVI,EW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
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DATE
COMPLETED
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Rev. 7/ZU14