HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONs
All APPLICABLE INFO MUST BE COMPLETED IiVKC"Id
Date: 3 20 �� Q �
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
TO BE ACCEPTED
Number:
BY
Lucie County
ing Permit Applicati
JUL 31 2919
ST. Luci�Permitting
Commercial —Ie� Residential
PERMITTYPE: ZVAAS � h, re p, e• S c�irS
PROPOSED"IMPROVEMENT LO''ATION . «` .x
Address: 3/vim R �Y�77er�1.S fir`✓ir T5o,-4 A'Eroe. .FL 3g9,gfo
Property Tax ID #: on cof p tin Lot No.
Site Plan Name: Block No.
Project Name: foie 5 F/i f5
e
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:
/00
Sq. Ft. of First Floor:
,5-0
Cost of Construction: $
!o, ")00. A6
Utilities: _Sewer _Septic
Building Height:
OWNER/LESSEE; •.
GONTRAGTOR:
Name F1ViA4or 0 ci
Age.
Name:
Address:3Soc:S C,61M
Company:--,,
City: taff �7L er State:
ZipCode:3`•fi'i(2> Fax:
Phone No. T12--83c1-G2,91
Address: h>
City: State:_
Zip Code:- Fax:
Phone No
E-Mail: 42-hr,'s e �-po
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.
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DESIGNER/ENGINEER: —Not
Applicable,"
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name. :•
Address:
-,Address:
City:
State:
City:
State:
Zip: Phone
Zip: -. Phone:
FEE SIMPLE TITLE HOLDER: _
Not Applicable
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 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."
Signs re r/ L see/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDAe--
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was a�ckpowledge efore me
The forgoing instrument was acknowledged before me
this— day of "14
20Lby
this _ day of 20_ by
Name of person making tatemenll.
Name of person making statement.
Personally Known 110" OR Produced
Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Prod ced
Produced
(Sign ure of Nota
(Signature of Notary Public- State of Florida )
�%tery PuMie Sfete of Fbdda
Co mission No. AleJendran GQA) 282343
CuTra G
Commission No. (Seal)
VOW. �W� ow2&z022
REVIEWS
FRONT
ZONING.
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.[/i/ly