HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE IVF0 MYST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �2 12A 11 q Permit Number: U---,q5
-Appk AR to —
Building Aermit lication
Planning and Development Services §JZNfl§
I.U4 @08ptMent
Building and Code Regulation Division count;'
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential Y
PERMITTYPE:
Address:- --).:3 1 A If]-rllo
Property Tax ID #:
Site Plan Name: -XI'*a
Project Name: �5'ql
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Lot No.
Block No.
I DETAILED DESCRIPTION OF WORK: I
I CONSTRUCTION INFORMATION: SL LuCie Countv I
Additional work to be performed under this permit -check all that apply:
XvIechanical - GasTank Gas Piping - Shutters —Windows/Doors
_yElectric )61umbing Sprinklers - Generator — Roof Pitch
Total Sq. Ft of Construction: - r'�-:511) Sq. Ft. of First Floor: 02-363 -
Cost of Construction: $ -7. Utilities: -Sewer _Septic Building Height:
OWNER/LESSEE: - -
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CONTR��-.
Name-. Y=-4*-dzv F. A
Name:
Address: OW U
Company:
City. state�"
State
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Zip Code: X:
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Phone JNo. 7�J2 7142
Addres 34L Lone- 72/;,W, Im
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E-Mail:
Fill in fees mple Title Holder on next Page (if differentu
from the Owner listed above)
E-Mail Sot/ M
State or Co- �J
If value of construction is $Z500 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.
PPLEMEN XCONST� TION
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ES16NE34VNGINEER:
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Name: RAI If
Not AppliT
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MORTGAGE COMPPNY:
Name:
— Not Applicable
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City:
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State:
FEE SIMPL
Name:
Not Applicable
BONDING CCITT:
Name:
—Not Applicable
Address:
Address: U Z;?�e
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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an9covenants 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
)130�TIEFD —ON-I&E J213 SITE BEFORE THE FIRST INSP'j�CXION-Kf YOU INTEND TO OBTAIN FINANCING, CONSULT
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WITH YOUR L E OR AN ATTORNEY BEFORE RECORDING YOUR NCITICIE OF COMMENCEMENT."
PSrg-n-al-01`6—of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this _ day of 20_ by
this _ day of � 20 by
Name of person making statement.
Name of person making statement.
Personally Known_ OR Produced ldentlficat!on�
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
V% 1" �
Produced
L—raymm
("nat6re—of Notary Public- State of Florida
-o-
f'o- y
V(Sgnals,,re o4kotar Pubfic- state of gj�rlda
Commission No. (Seal)
Co
Co ission No.
MYMMMISSIONOW275
ExPP1s:December20,20
REVIEWS
LANS
V EGETATION
C L1
REVIEW
REVIEW
KEVIEW
-REVIEVUr—
DATE
RECEIVED
EXPIRES' . Dew
20,21122
DATE
....
COMPLETED
Rev. z11119