The URL can be used to link to this page

Home My WebLink AboutBUILDING PERMIT APPLICATIONALL APPLICABLE INF9 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Ce l SCANNED Permit Number: ��bG'oo01 BY r� I _ St. Lucie County =RECEIVEDBuilding Permit ApplicationPlanning and DevelopmentServices Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1575 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line W�v� haw PROPOSED IMPROVEMENT LOCATION: " "34 Address: �, ,,gyp Legal DDe`s`cripption: d `ten :3b L (�4 Property Tax ID #: el ' 9� 1 ocn a cco IVA Lot No. Site Plan Name: Block No. - Project Name: V c Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: s� tIJ1 © � YI - 3 5e xm-k- ti jadwS CONSTRUCTION INFORMATION; Additionalwe to Die berformed under tispermit—check all apply: 0HVAC 0❑Gas Piping 11 aWindows/Doors Gas Tank _Shutters 11 Electric 0 Plumbing Sprinklers C Generator Roof Roof pitch Total Sq. Ft of Construction: S Ft. of First Floor: OSeptic Cost of Construction: $ ��m ' Utilities:Sewer Building Height: OWNER LESSEE: CONTRACTOR: Name 75 Name: �e r �-/ Address:Z)aY4-JYJ--PCN ISAc%so Company: 5E79PoirTr %ju./dElzS City State: Address: oil &-ec-4 Avice 44- City: R� f�i'tW r' State: �L Zip Code: Fax: Phone No. . ^ 3 Zip Code: 2111"1 Fax: E-Mail: Phone No. -77A 3137- - I l �i !c /-/ E-Mail: ,. f�bv,/�c/� 5 * 00e C.45 L� • Ug-t Fill in fee simple Title Holder on next page (if different State c County License: from the Owner listed above) If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. i SUPPLEMENTAL CONSTRUCTIONLIEN. LAW INFORMATION:'` DESIGNER/ENGINEER: Name: _ Not Applicable MORTGAGE COMPANY: Name: _ Not Applicable Address: Address: City: Zip: Phone State: City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: Name: _ Not Applicable BONDING COMPANY: Name: _Not Applicable 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 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 jobsite before the first inspectt'}'aan. If you intend to obtain financing, consult with lend rn n y#fefore commencing work orifecordinR vDur Notice of Commencement/, /� Si ature of n r/ Lessee/Contractor as Agent for Owner ature of Contraor/Ucense Holder T OF LORIDA C N OF 5�C. \uG\2 STATE OF FL A COUNTY OF The (orgoing instrylnent was acknowledged before me R The forgoing nstrument was acknowledge before me 7S V V\ this'\ day of J V IV\ a 20 by thisN_ day of 201A by 5 O v� acIZSO Vl JTo y\ �dvc %254n11 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 Identifi�ation Produced ti L Produced \`l. Y\ L (Signature of Notary Public;,StateatFlan ENs {I�� (Signature of Nota Public-.StateaoSFtond" -- •• DEAN AM{U2IEGNENS I� P;" f p cAPlNAMARJ 1 Commission No�a.-�Kn�ICDMMIS5101�3i ZOiJ gr` �$'��'�.' W co It71s 0, p GG 022023 Commission No. `t.Co t'a.2020 --='' �-;-tuber ' E7tpIRE5:D Th NNotaN Pcbr'cUppe�¶iers 4 P ubli eUn de;wdteID Bonded7hWNotzryd '+;Ro bonds �i:°.•• REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE 61016 RECEIVED DATE COMPLETED Rev. 8/2/17