HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
ECO
Building Permit Application OCT 2 0 20b
Planning and Development Services
Building and Code Regulation Division PERMITTING
2300 Virginia Avenue,Fort Pierce FL 34982 $t.Lucie Count;%, I=1-
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential—
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED (MzPROVEMENT.LOCATION
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Address: fo l S2 5 �w0ca* Diu[4C �2-0C
Legal Description: ka&�,Ti � C61V40 &Q6 / aMT'S 320Ia-
o��d" c2 014l.TO e7 b
Property Tax ID#: yf()� X27-Com-3 Lot No.
Site Plan Name: ni/�LA Block No.
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Project Name: V/LA'
Setbacks Front Back: 1"04 Right Side: Left Side:
DETAILED DESCRIPTION QF WORK
2 1�140�7we.7- 2 aeaVIA-Gs _'2XJ
CONSTRU"TIO N INFORMATION 5
Additional wor toe e orme under this permit-check a app y:
1_1HVAC' F Gas Tank []Gas Piping _Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$��i Utilities: _Sewer[]Septic Building Height:
OWNER/LEEE ;£y z CONTRACTOR
SS
Name II- Name G/ nJ
Address: �{Ti(o W (5i 6-,2(�rrryo Company: )L-A r&, / / G
City: Cie ISfo"i State: t"t- Address: 7ZU
Zip Code: ?,?'J c(c) Fax: City: fA&f7it.T Stater
Phone No. Zip Code: -clg4!'f Fax: 6-/Z -!F7Y�/
E-Mail �
E10 4J/c�r4 ELLS,>0 774./ye-T' Phone No. & q1 _,0L-)q0
Fill in fee simple Title Holder on next page(if different E-Mail: X/iG/� iLe_ t
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFO'RMATI0N
, .,
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n.
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:
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 thepermit 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 inspecti n. If u intend to obtain financing, consult with lend75rr attorney before
comr-genci,pg wor or r1coroAg your Notice of Commencem
s
ignature of Owner/ sse Agent Sign atb re of Contractor/Lice se
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF v ,4-UC/F COUNTY OF .ST 4UC1,
The fo,,,,rr�oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this/` nnday of t0"7D cgEA 20/,�y this/rAay of(�_7D6 ,I! 20Z_27—by
(Name of person acknowledging) (Name of person acknowledging)
(SignaturE-of Notary Public-State of Florida) (Signatt re-of-Notaryubl� ic-State of Florida)
Personally Known ✓ OR Produced Identification Personally Known_�OR Produced Identification
Type of Identification Produced Type of Identification Produced
' Y%"• AN UMOND
Commission No. ? ��II--��,{{ Commission No.
MY COMR55iflW#FF 173907 �wxry'• ANN M.OAUMOND
•, P EXPIRES:December 7,2018 .-:q' �c
Bonded Thor Notary Public Underwriters MY COMMISSION#FF 173907
'F' �c°` Bonded rwr
Thru Notary Public Undeiters
Revised 07/15/2014 Pf"
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS