HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
COUNTY
F t. n R t C
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
Building Permit Application
Commercial
Residential X—
PERMIT TYPE: F_ �_C—cG 1 R l C-14 L_
PROPOSED IMPROVEMENT LOCATION:
Address: i--i''J Q C'YL L-0 W C DR i FORV ?I ERC-C _
Property Tax ID #: '� 308 — 121 — 0000 d000 — 3
Site Plan Name:
Project Name:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: 1-=] MR IN P'Z6 (<-e(
CH(ANAG L CUT EX ISTI ►�ICr IN Q & 0 R 2QQ A M F PANEL. TIO
NEW 1)�lIda0R> 200 Ary(p MAIN BP2C—RI{EK PPvNEL.
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: $ �2' 000 "oQ Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name LI-I Ri STA L STLJ Hj'R-
Name: (_ kf( RLE6
Address:_o RR •
Company: (!NRV_L_' t> 1-ow EL.ECTZiC Tmc-
City: Fc>fLT 1Pi of e State: �
Zip Code: 314945, Fax:
Phone No.
Address: 45 Z HC-RNA)J l�C
City: VORLT Pi 6kQ e State: EL
Zip Code: 3 }-i 9 H C( Fax:
Phone Nc{ 7 7A) -332 — 91 &&
E-MailG]•.OWe E I,EGTIZIC1NC% 6D, C L,01 > Cd M
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License f�—_R co 15 1 1 1
If value of construction is $2500 or more, a RECORDED Notice of commencement is requires_
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Name:
Address:
Citv:
Zip: Phone
— Not Applicable
State:
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
Citv:
Zip: Phone:
Not Applicable
State:
BONDING COMPANY: _Not Applicable
Name:_
Address:
City:_
Zip:
Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as inaicatea.
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
WMLI vn"n i CWnCn nD AN ATTnDNFY RFFnRF RFCARnING YOUR NOTICE OF COMMENCEMENT."
lr /
✓"� �-
ignature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF S4 . Luf �e
COUNTY OF cie
The forgoing instrument was acknowledged before me
The forgoing instr ment was acknowledged before me
this I S day of I Ce v,he,, , 2019 by
this 13 day of L)Ccern4_pe%/ 20I'q by
C �cty le s 'E LbWt
ChC A(!_s E LU J L
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 Identification
Produced
Produced
TCL�-7
Signature of Notary Public- Stat o a )NotaryPublic Staa9otFi
Public StaieofFkxida
(Signature of Notary PublicRo,,,_
�• Evelilin�da+Flores
Commission No. C� 343IVIy�ldo�yrt-sslonGG383182
E�c�S, af0712023
�xr.tGOMWM3ores
ommission No.G�� 363 ii32arro S4ionGG383t
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/ 19