HomeMy WebLinkAboutBUILDING PERMIT APPLICATION< y
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT TYPE:
Address: 3!5-6 E/15'%' f TWA I
Property Tax ID It: >�3�/9 ; 30 D/
Site Plan Name: /elver- pkle-4
Project Name:
DETAILED DESCRIPTION OF
I�EWobE7] �' LSE,
Residentia
UlJ 6
SCANNED
BY
St. Lucie County
v
3¢y�3
DDO / ,'' / Lot No. 2
t K38 4/ r1.�� �128'V Block No.
Avp
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers —Generator
Total Sq. Ft of Construction: 3/� Sq. Ft. of First Floor:_
Cost of Construction: $ 8d9co.UO Utilities: _Sewer _Septic
Windows/Doors
d Roof &:l L Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ! 5 �%%�F� �lE2L/G� %'
Name: l-770050 LOPE
Address: 3.56E I�JWd (/!( 414V
Company: gyve d E
City: ZIP g E
Zip i� % 1 State: L
Zip Code: :5 i4 F8 9 Fax:
Phone No.
Address: 9�AD,*.64. ;ea -
Ctty:624Y 14W State: hL
Zip Code: 3 3 el" Fax:
Phone No �' 7�D •- �0 6$
E-Mail:
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.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
c I l
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name-
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIOVTT: 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 antl 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, 1 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 accessary uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMN
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF C
POSTED ON THE JOB SFFE BEFORE THE FIRST INSPEC7E@tll: IF YOU
for Owner
STATE OF FLORIDA, STATE OI
COUNTY OF/JLtN COUNTY
The forgoing instrument was acknowledged before me The
this 8 day of "6ZZ . 20 19 by this
Name of person making statement. Nan
Type
NIT MAY RESULT IN YOUR PAYING
EMENT MUST BE RECORDED AND
TO OBTAIN FINANCING, CONSULT
acknowledged before me
. 20 1`f by
person making statement.
OPo@vodueedldentifition I Personally owl{••. denti
Notary Public -State of Florida Typed �'�" •d`•— EVORA CRUZ
CommissionAGG 184200 _ `` Notary Public - State of Florida
`I om za, aoza Pro ced PMM
00
aI Naotary Assn. F\ .�•.,P,Pt�9 MY Comm. Expires Mav 2a.)m,
National
State of Florida )
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR I PLANS I VEGETATION SEATURTLE MANGROVE
COUNTER I REVIEW I REVIEW REVIEW REVIEW I REVIEW REVIEW
RECEIVED