HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE I PLETED FOR APPLICATION TO BE ACCEI Date: Permit Number: I4 � q-om,
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
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: YDy7 SPENA7=/':T� LM/6
Property Tax ID #:
RECEIVED
SEP'05 2919
PermittSt.Lucle County
ing rtM@nt
Residential �
Lot No. Ss-
- -•— wwwrrfp
Site Plan Name: % /Y/ A�J/ rU / IC'CS(6 C-A" Block No.
Project Name: 5^6 LE Grer-a P11A56 -Zt
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
Mechanical VGas Tank ✓ Gas Piping _ Shutters
✓lectric Plumbing sprinklers ✓Generator
Windows/Doors
✓Roof (O /a- Pitch
Total Sq. Ft of Construction: 75.2V Sq. Ft. of First Floor: 752 /
oa �
Cost of Construction: $ �'z,/,3�,90 Utilities: —Sewer _ Septic Building Height: 2'7
OWNER/LESSEE:
CONTRACTOR:
Name ZlTr-C-R i9LA70i1
Name: &UN R��r
Address: 7%9-1 _51MPIE 4L5 - & '
company: 7ZI&E 60109YS /-L-0
city: ppe7-5T 411elE State: tl
Zip Code: ,3119?(O Fax:
Phone No. 973 - v/7- Q2
Address: SV IM 6P6(Ja77{_/ri LN
City: State: �
Zip Code: 66ft Fax: 77a 015-/9-V
Phone No -17, -:2(,P0 4W()
E-Mail: zRFle/r7,fM,,W Vj 9) Ei"&L. e&d
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail �1 R?i E.UEO7f�GLLSI�JfH /11G�
State or County License 0C7C 15.1. 15
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.
5�A
r.
PPLEMENTAL CONST ION LIEN LAW INFORMATION
DESIGNER/E}UGINEER: Not Applicable
Name: efiU
Address: 5£ fit 4
City: State:
Zip: Phone 81//- cRVS7
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address: ii A
City:
-Zip: - Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Address:
City: _
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 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 SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER ORAN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
$ig a0 "_f;Owne Lessee/Contractor asAgent f
STATE OF FLORIDA
COUNTY OF
The forgoing instru ent was ac nowledged before me
this day of . 20 , by
2ciA/ ►o,/2.man)rti
Name of person making statement.
Personally Known OR Produced Identification
Type of/lpentification
Pmducdd W//7f
A (o/�/�
Signature of o tractor/License Holder
STATE OF FLORID t �%
COUNTY OF �L(�i
The fgrgoing instr ent was ack 3wledgedJ?efore me
this day of 20 by
i ��
Name of perion making statement.
Personally Known OR Produced Identification Ll�l
Type of IdentooRio ,
Sign tur of Not�Public- State of Florida) JENNIFER J. BUL
'�v�y`� NOTARY PUBLIC
ommission No. �i (-�w�� STATE OF FLORI
Comm# GG350711
gSign ure of Notary Public- S a rid
�c
� n
PCommission No. /
v.
1 r cryiw U1.0 ,e of Flo ri
�JbCo missi . State of 808
Am.exiire GG57808
(��I�m, expires Dec.22, 21
_ sf
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