HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAII'APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: N -
1 •
- - 604in Permit Applica ion lanning and Development Services BY OCTo1 82019
Building and Code Regulation Division StPermitting itti n
2300 Virginia Avenue, Fort Pierce FL 34982 . Lucie County St g Department
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial R Cie County, FL
PERMIT TYPE: Mp1 (_,, .
PROPOSED
IMPROVEMENT LOCATION:
Address:
Property Tax ID #:
Q
00 — Lot No.
Site Plan Name: 1 Block No.
Project Name: S 1
DETAILED DESCRIPTION OF WORK:,
1"m; / l a 0okn�
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: Sq. Ft. of First Floor:
Cost of Construction:$ �� 3(�-Oli Utilities: _Sewer _Septic Building Height:
'OWNER LESSEE: " '
CONTRACTOR:
Name
Name:
Address: .1 r 1 Vk,.
Company:
City: State:TL
Zip Code:alLfFax.T
Phone No. qla—
Address: P,i^
City: State:
Zip Code: Fax:
Phone No Tl — —
E-Mail:!Ai RIM IS4jOY1l✓i1 Ii
Q�5j7r-,>i
Fill in fee simple Title Holder on next page (if different
E-Mail r -W
State or County License
from the Owner listed above)
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/ENGINEE _Not
Applicable
MORTGAGE COMPANY:
Not Applicable
Name:'
Name•
_
Address;
Address:
City:
State:
City:_
State:
Zip: Phone a-
—
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.
1 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 STiE`iBEFORE THE FIRST;INSPECRON. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR'AN AITTORNEY, BEFORE RE URDiNG YOUR NnTICF OF CnMMMCIPMEW7 "
Agnature of Owner/ Issee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORI
STATE OF FLORID
COUNTY OF . L.1•� �e ,
COUNTY OF�C' I ��
The forgoing instru enIt was ackn wiedgebefore me
this �day 0 by
The forgoing instrument was before me
of
this�dayof 20 by
'I�OirinrrG .W,IIio I//LS
ln9iI/jaVAS
Name of person making statement.
Name of person making statement.
Personally Known V OR Produced Identificati
n
Personally Known OR Produced Identification
Type of Identification
", w
Type of Identification
Produced
Produced
,,.,,,
';mn.•
.R
(Signature Notary Public- State of Florida)
.� !.
(Signatu of Notary Public -State of Florida)
Commission No. BSI 459 (Seal)
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Commission Nona_ (Seal)
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REVIEWS
FRONT
ZONINGRR���'15�
PLANS
VEGETATION
SEATURTLE
MFm
COUNTER
REVIEW
81
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
�.
COMPLETED
rteV. L///1`J
L � \
All'APPLICABLE INFO MUST
/aBE COMPLETED FOR APPLICATION TO BE ACCEPTED / 1
Date: 1 1)' 1 $- lvi Permit Number: / -/ /� / iv' J� -
Building Permit Applica
ion OCT 18 2019
Planning and Development Services
Building and Code Regulation Division
Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982
(772) 462-1553 Fax: 462-1578 Commercial
R
Scia County, FPhone:
'
(772)
PERMITTYPE:21�1
PROPOSED
IMPROVEMENT
LOCATION:
-.
Address: 3
Property Tax ID #:
Lot No.
Site Plan Name: SS 1
Block No.
Project Name: I
oZ
DETAILED DESCRIPTION rOF
WORK
ler
<a�r /" Yrn ,
J
CONSTRUCTION>INFORAAATION
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$-Oli Utilities: _Sewer _Septic
-Windows/Doors
_ Roof Pitch
Building Height:
O1MNE 'LESSEE';`
CONTRACTOR
Name
Name:
Company:
Address:q-lr
city: State: f!
Address:
City: State: !L-
Zip Code: Fax:'% ` r
Phone No. _r7` a ! a
,_i
Zip Code: Fax:
Phone No
-a-
E-Mail: f�ificl orn is6CMA i �rIi rii of s do
E-Mail r ('0
Fill in fee simple Title Holder on next p( if if different
State or County License
from the Owner listed above)
If value of construction Is $2500 or more, a RECORDED Notice of Commencement Is required.
If value of NVAC Is $7,500 or more, a RECORDED Notice of Commencement is required.