HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:_ r10(lg Permit Number: 1 V U
;S A Y Fn
EIVED
9VLU (eCounty
• Building Permit Applicati12 2o1sPlanningand DevelopmentServices
unty, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMITTYPE: PV Sckar
PROPOSED IMPROVEMENT LOCATION:
Address: 561 0Q .SQc Lnq Uale- I eP_1'i" ce, (A Lucie— I FL
Property Tax ID #: /_3/�o� - 5oa - G 1 V 5'- r'X7C' -I Lot No..398
Site Plan Name: rruci P i= Block No.
Project Name: 6r(eal ef/ L/)ce'
DETAILED DESCRIPTION OF WORK:
9F KW PV X()1QV SWICM
CONSTRUCTION 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:
Cost of Construction: $ 11 COS
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ` &7hlb
Name:_ Gv9--6wr\t Girl CoCIYI��
Company:_ Ctiti G CICCk-cCPA nC
Address: 71Co17 Prc)"Cp7c-V Per,re
City: WR 5 k\1 Cho U Stater
Zip Cc; 3354 Fax: H
Phone N0AO) o11�S- ci$bl
E-Mail perm(F 6) s�efup jaiU solccr to
Address: ci
L
City: Stater
Zip Code: Fax:
Phone No. 30,4---18tI- YL131
E-Mail: di'l *U hV %� aal, clot"
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License_ QC�3D015SCz�J
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.
MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:'
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable I BONDING COMPANY: _Not Applicable
Name:
Address:
City: - — - -- -
Zip: Phone:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDAVIT: 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 OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Signature Lessee"%Contr�ctora_s AAgentfor Owner
"�..1
Signature of� Coda rector/license-_Ho er_)
STATE OF FLORIr
STATE OF FLOR
COUNTYOF Q'C4jCO
COUNTY OF 0.SCC)
The forgoging instr me t w,a§ acknowledge,f� before me
The forgoing instr men was cknowledge before me
this �� ay o1 2011 by
this (�fhlay of p D� • 20 by
1 f P(1 (yM PSI
G CEA Ccx nk, l
Name of persog making statement.
Name of personimaking statement.
Personally Known�, OR Produced Identification
Personally Known OR Produced Identification
Type of Identificati6n
Type of Identification
Produced
Produced
(A FM mlC,�-
( ignature of Notary Public -Ste o F o i a
(immature of Nouye
r .�n N ary Pudic State of F
Commission No. dJ a3 ? Se anda C McCormick
3277%�A
�Ny Pubiie State of Floft
Co mission No. (19e dmCcCormGG 3 McCormick
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