HomeMy WebLinkAboutapp (2)II APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _ Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application AUG 4910M
Permitting asartment
st, l.uc-ie , Rly
Commercial X Residential
PERMIT TYPE:
PROPOSED IMP:ROVEMENTIOCATIO.N
Address:
rA
Property Tax ID #: 603 r (l Off' S DOD j� Lot No._
Site Plan Name: Block No.
Project Name: o%-C-
OETAILED DESCRIPTION"OF'WORK:
i.
_?000 PST_ t�il9�Ai co'c-ro(e r l
CONSTRUCTION- INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _/ Roof Pitch
Total Sq. Ft of Construction: Leo 0 a ��"') Sq. Ft. of First Floor: �!F7
Cost of Construction: $ J ,�j. 0. Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE-CONTRACTOR:
Name 60jz. ,00t.; D'J
Name: ba r
Address: ��� S� i 44f
Company:_ 9E" z.:v�d -�-%� C.
_
City: b .• t'State: F`
Zip Code: Fax: TuA
Phone No _[ `� 916 �,�' g
Address: cro� `•. ce, fie.-*, �
City: r State:
Zip Code: - ysx Fax:
Phone No r J/
E-Mail: « ^AY`• Ad
Fill in fee simple Tit a Holder on next page ( if different
from the Owner listed above)
E-Mail oU c CC)'
State or County License 0
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.
L
Adk
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
I
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: XNotApplicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
i
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 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
ITH YOUR LENDER OR AN ATYORNEY BEFORE RECODING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/ ntractor as Agent for Owner
Signature of Contractor/Lic se Holder
STATE OF FLORIDA n , �Jt
°
STATE OF FLORIDA
Sa`
COUNTY OF S -'C,�: .Q�.
COUNTY OF �
The fing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
thisdayof_17 20C/ by
this 4�ayof 20f�by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced G�Z�
(Signature of Notary Pub ic- State of Florida)
(Signature of Notary Public- State of F on
Commission (Seal)
Commission No (Seal)
it
Y pv'ii ELLE ,Q
State V"
'UGH
REVIEWS
F PAa�� °m
''°.Ff�CSNTMY�
ission # ° ary
�Zp
PublicFL(
OR
resR
PLANS
��g``_
a
-MANGROVE
t�
IEWUP
REVIEW
IV°j
�,5}f °ta
/RE�IEWIR
t
—
OctDATE 0he 1011
2.2
c
� �s
RECEIVED
es
DATE
j
COMPLETED
Rev.
pUm I °"ll
13
/' I e�IL- -J If
a0. zz
� 5 <
ZZa
PENNY LANE m C
oa/P/Pdu✓ ®.w....m,.mry� �. iF
CVACI
1ROn
®.0 3�0 sky
eO�i�4r / / ! �gp�m0►� G m
\ \ Y ARNOLD SURVEY/NG, /NC. '�-�3`-ate ,m, ee3e,���3
CATC BASAISC ,tE