HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLE.`.�. .. i°OR APPLICATION TO BE ACCEPTED c�
Date: 3 r\ Permit Number: V (J"! 0 3�
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LR;ai-m IN
Building Permit ApplicatiPlanning Enc:
and Development Services tting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
ANIhipp
PERMITTYPE: E4Y
PROPOSED IM ROVEMENT LOCATION:
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Address:,.wZS S
B \-t(MP-U) 00C� (!_I 'Fm�rt
Property Tax ID#:Fnto —Rot—eC)t--0oo—q Lot No.
Site Plan Name: Block No.
Project Name: ®olAV- • �oJ�
DETAILED DE GRIPTION OF WORK;
n 0i x Z- G L Y 10+1q & 42 e. a Vt e,
6youA A.,,,-Ao rs A"E cope- K e iiodu I�rnsf cvtA �yevY oA
CO STRUCTI -N 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:` G CP Sq. Ft. of First Floor:
Cost of Construction: $ F ��� • 5� Utilities: _Sewer _Septic Building Height:
O .NER/LESSEE.,
CONTRACTOR:
Name OAS AS
Name:
Address: ?� $ t
W tr IJU X
Company:
City: ^ v {�V'Qei State: �i
Zip Code: Y Fax:
.Address:
City: State:_
Phone No
Zip Code: Fax:
E-Mail: �04NW MJ. �ONn
Phone No
Fill in fee•simple title Holder on next page ( if different
E-Mail
State or County License
om thelQwner listed above)
lue of construction is $2500 or more, a RECORDED Notice of Commencement is required.lue of HVAC is $7,500 or more, a RECORDEDNotice of Commencement is required. IV1tG�y
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SUPPLEMENTAL CONSTRUCTION LIEN LAWJ INFO
MATIQN:
DESIGNER/ENGINEER- /ENG,�I,N/EER• _ Not Applicable
Name: e.Adi/C2s. n e' /_v-'a and
ORTGAGE COMPANY: _ Not Applicable °
Name:
Address: .OS Lttsir AMK arejAddress:-.-
City: State:
Zip: }. 2.a Phone
4T
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address: t
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 h ymay restrict or prohibit such
structure. Please consult witour 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
WITH Y END R OR AN ATTORNEY BEFORE RECORDING YOUR NOTI[E OF [OMMFNCFMFNT_"
LJSgna ureuce caner/ Les a/Contractor as Agent for Owner Signature of Contractor/License Holder
TA5 TE OF FLORIA STATE OF FLORIDA =
COUNTY OF 5}. �. oc�� COUNTY OF
The forgoing instrument was acknowledge before met The forgoing instrument was acknowledged before me
this day of V\ C 20 N by this _ day of 20_ by
A0,0Lg,'(.0'v3
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 L- Produced'
(Signature of N (Signature of Notary Public- State of Florida )
"""�''• REJ
Commission Na Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED