HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPUNED FOR APPLICATION TO BE ACCEPTED -
Date: 51�1 �� Permit Number:
SCANNED
BY St. Lucie County Cion
Building Permit ApplicaPlanning and Development Services itting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE:
Address: 4.le2q L—
i
Property Tax ID #:
Site Plan Name:
Project Name:
Block No.
C0NSf,0lJCTION INFOFtiWATII'N: X AIX
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:
Cost of Construction: $
Sq. Ft. of First Floor:
Utilities: _Sewer Septic Building Height:
OWNER/LESSEE:': °
CQNTRACtOR.
Name ; iX „ %7 . ,
Name: fz&Q 2, )
Address: 27
Company:
City: ✓ State: �
Zip Code: 7 Fax:
Phone No.
6�t�ay,
Address: /3g5-26 Qr /Q✓ss _ _ _ —
r Stated
City: State:
Zip Code: ]! �� Fax:
Phone No '7
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.
r"
mom 7
SUi?L�{VIENTAii
iCON5TR1JCT10N. IAW IIyFt)RMATIOi, ' ,' ': y.�
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Applicable
Name: zzs ra„r
Name:
Address: gO
Address:
City: State: fi -
City: State:
Zip: aa$9&e2 Phone 72a-moo-Sty
Zip: Phone:
FEE SIMPLE TITLE HOLDER:-WorApplicable
BONDING COMPANY: _Not Applicable
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.
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 Home Owners Association
conflict with any applicable 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work orrecordingour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORID/�
COUNTYOF j
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
thisdayof7ltiffr 20/gby
thdayof —Ad66m<, 20,:�Eby
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known �— OR Produced Identification
Type of Identificati n
Type of Ide'
Produced 1gMFmdda
Produced o1efY-Pub
Frederick E Adams
FeE Ada -fide
' raddck dema
m mission Go 067655
0312612021
MY Commission 087855
an 'res
oIM1�1 Fywf
03I2aR02121
(Signatur of Not ry u ic- tate o lorida)
(S1ture o otary Public- a e of Florida
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 9/26/18