HomeMy WebLinkAboutapplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APP! (CATION TO BE ACCEPTED
Date: n2 - 7 --2 00,0 - Permit er__
Building Permit A p,licatf"! 7 2020
Planning and Development Services Permitting Department
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Building and Code Regulation Division
Lucie Count
2300 Virginia Avenue, Fort Pierce FL 34982 yr FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial I Residentia
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=PERMITTYPE:Co � C r-e �eED
IMPROVEMENT LOCATION:
Address: - /-1 D 9 ZAJ.gfr,u/I� 7 . Ff. P'yrce
f02 1� �S /f
Property Tax ID #: 1'Y A -S2 )—O • " '9 0 �� Lot No.
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Site Plan Name: 00 U D Block No.
Project Name:
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DETAILED DESCRIPTION OF WORK:
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Y'l TA Cc k�e65 al� %E eO re(efAWffr1 -aAd el 41e,1(< to
3000 P54 FT&geME5F/ If .,,I( IJa Vey. 1. i '�v r� IL).
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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 _i Roof "Pitch
Total Sq. Ft of Construction: 70 0 Sq. Ft. of First Floor
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Cost of Construction: $ 5-6l, Utilities: _Sewer Septic ptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name [-eliy Pe. n F&O r� \
Name:
Address: 3q09 ?7r651.
Companyr/ra 6Y- C anrracT n; '�dct
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City: F% L(tri[p - State: CC
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Addr ' s v L,`{�a
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Cit i rn
Y G>r: er2rct� State: FL.
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Zip Code )I�ig's ura�?;F.ax )�i r> .�
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Phone No� 79�"�r6 2[a! $ ` 11
Zip Code.,=3y r1Sl �- Faz:
E-Mail: +"v i J'iciV"n e / y
Phone No 7 712 - P 16- 641�2
Fill in fee simple Title Holder on next page ( if different
E-Mail vt /C,A C-5p ifd �
State or Cou ty License C C7 C lfo71S8
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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.
UPPLEMENTAL CON TRUCTION L EN LAW INFORMAtTION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 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 fespects,"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 IMPROYEMENTS 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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of Owner/ Lessee/Contractor as Agent for Owner Sign— tu�Contractor/License Holder
STATE OF FLORIDA�A - STATE OF FLORID�A
COUNTY OF ( � 4COUNTYOF�7411 • kre,G
The for oing instrumq{t was acknowledged before me The forgoing instru nt was acknowledged before me
this day of c�=jo.,1 . 20-',til by this I day of }, , 20,E by
Name of person making statement. I Name of person making statement
Personally Known ',_� OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Vo
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(Signature of t'ar'y PubTi'c- State oOloridaV
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REYB. PHREY
Commission No
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Commissio m
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