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Home My WebLink AboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED hh� Date: - Permit Number: V SCANNED LANNI V St. Lucie County p qOq `Fa Building Permit Application s;,9 22 joo Planning and Development Services <��0oepv Building and Code Regulation Division COS no 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMITTYPE: Re, -pooF shin1-0 r-laf Address: -f- f= o r 1" Property Tax ID M. Z 14 19 O I —0 0 LIS- D3 o 4 Lot No._� Site Plan Name: Additional work to be performed under this permit -check all that apply: _Mechanical _ Electric _ Gas Tank _ Plumbing Total Sq. Ft of Construction: 120 0 Cost of Construction: $ (0 I —1 to .IJ o —Gas Piping _ Sprinklers _Shutters Windows/Doors _ Generator —Windows/Doors _�� Pitch Sq. Ft. of First Floor: 12u0 Utilities: _Sewer• _Septic Building Height: 0WNER%LESSEE_- - r �-w < CONTRACTOR+a' a"T Name cL rl1( (rys-t- Name: JQdn -Ftnfz Address: PU_13U7( 1-q(o3 Company: Total 2ou(11n kh City: rd K -f Pr f/re.. State: FL Zip Code: 3 y 9 S() Fax: 7-77_-672—�033 Phone No. 112- K72 - $0 3 0 Address:.3 2-0 1 SF awa' rt i C- fc A c City: Siva ✓t State: F[- Zip Code: ,: 'q 9 9 i Fax: No -I 1 2- C-7'2- —9_63 o E-Mail: 0Mtr&,Q4T1JV1 COQAAS11-Veftri7g-tPhone Fill in fee simple Title Holder on next4 a (if different from the Owner listed above) _ E-Mail S� YA® ii 1 r.i �fi L �.s wf t State or County License(_ CC 13 Xt� ._...- _......•.., o ...��..�� ,....,uc w, wnnnencemen[ is requirea. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. THERESAJAFFE Notary Public - State of Florida Commission B GG 202301 through Ll SUPPLEMENTAL CONSTRUCTION LIEN LAW.INFORMAT(ON DESIGNER/ENGINEER: Not Applicable T MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone �^ Zip: Phone: FEE SIMPLE TITLEHOLDER: _ Not Applicable BONDING COMPANY: Applicable _Not 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. 1 certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conict with any applicable Home Owners Association bylaws rules, or andcovenantsthat 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 SlITSpiBEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDE N ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signatu of OtLessee/Contractor ge o Owner Signatur Contract or/Llcen o ATE OF FL ATE OF FLORID COUNTY OF COUNTY OFMartin The foFgoing instrurpent w�s acknowledged before me this f_dayof�(^ Pli 20 III by The f r oing instru ent w acknowledg d efore me this: dayof ,20�by ice' J Uo�� Q,✓ -t'L \ 1 U a � 1' C,_ J T'.lnt'L Name of person making statement. Name of person making statement. Personally Known )_ OR Produced Identification �1< Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notaryn� c- Stag Florida) (Signature of Notary u Scat f Iorida ) Commission No.Q�o N-3G I (Seal) Commission No. G }$(}( (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. ,1'var aoa, THERESA JAFFE r':N0,=ryPbft-StF,1,11d1FFE '?°; • ^•3 NotaryPublic -State of Florida .Ae of Florida •P Commission # GG 202301 •a• G 202301'Apr 1, 202E oanaeo lnrou8u"ation 0 1 notary Assn. Ba00e0 [nfwa�� ••�••-•