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HomeMy WebLinkAboutappAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 11 11 �( Date: \ �� Permit Number: I i O 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: (4-11 00P ( me[ 4 RECEIVED Building Permit Applical ion JUL 0 8 21319 Sr. Lucie County, Permitting Commercial Residential X Address: 116 51_ c'a".'^o 54 fal SJ LuCJP J � cly'Sa2 Property Tax ID p: 3 4 )Q- S Is - 0:) S R - 0 OO 4 Lot No. Site Plan Name: Block No. Project Name: /•ear nGG sM;�y/e5 Jn5)a11 ��1� ��1 a.kA S FAA kl Additional work to be performed under this permit -check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator 4Roof WlzPitch Total Sq. Ft of Construction: 1100 Sq. Ft. of First Floor: Cost of Construction: $ g oo0 Utilities: _ Sewer _ Septic Building Height: 15 W\/, Name 'Ra4'aIA A, )e, fR. Address: IIG o 1" Sf _ City:,?arl 5f 10C; c Stater( Zip Code: '� Lf 1S 2 Fax: Phone No. E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Company: ji , .+ti L L C Address: ,21 V :5t AA.:kJh frr City: 'rIr � 51 L u c � e Stater Zip Code: `;Li ss 2, Fax: Phone No_ ?X2 -Sol -7033 E-Mail_I©0110 0A•Ca: State or County License c C C 13.31g �o 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. EN DESIGNER ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: 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, accessary structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use "EARNING 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 WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." j` 1a�4 SignatWof Owner/ Lessee/Contractor as Agent for Owner Sig5it7e f Contractor/Lice se Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF L COUNTY OF The going instr en was acknowledged efore me this day of 20 by —i7l The forgoing instru ent as acknowledg efore me g this Y day of 20 ( by � YI , ka rrucivi-tP r l fl Name of person making statement. Personally Known OR Produced Identification Name of person making statement. / Personally Known OR Produced Identification V Type of Identifilft n Type of Identification Produced Produced 1 (Sign ture of Notary Public- State of Florida (Si nature of Notary Public- S KAREN S. E_�,$ EN Commission .° •°""�, �$q lorida- Public - C41 ommission A GG 207484 y —mission Ex ires Commission No. „M•, KAREN S. NIELSEP =w pS J f Florida -Notary SIpq - - om'/nimmi si n x ='ap„ioc My Commission Expi u r a REVIEWS ''P;n •° June 12, 2022 VISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER I REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.