HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
`LAG L1U' E
LF
_10 ° c Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: hcx7�ku p (" C t -1Y LU6_+e4-- )
PROPOSED IMPROVEMENT LOCATION:
Address: �l`0fl Pl-Ct e- T�f v
Property Tax ID#: .499.-60gTc')v25k_ Lot No.
Site Plan Name: Block No. 2
Project Name:
DETAILED DESCRIPTION OF WORK.`
f i<c � r�s fc nor f P'erLt? C_'(':
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
Mechanical —/ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Pond
_ Electric V Plumbing _ Sprinklers — Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ _ %C� e C-
Sq. Ft. of First Floor:
Utilities: Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ,f- 't rl
Address: ;Z7[ 0 0 t~ (cZa_�c�J4 46
4 t6 ba
e
Name:
Company:
City: a , f"e VCe
Zip Code: 3L 9S-2 Fax:
Phone No.
State: FL
Address:
City: State:
Zip Code: Fax:
Phone No
E-Mail:h !� Gird C�- S D 0 i 17G
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 HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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:
Address:
City:
Zip: Phone: -
BONDING COMPANY: Not Applicable
Name.
Address:-
ddressCity:
City:
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before comrpencing work or recording your Notice of Commencement.
Rev. 5/6/2U
Signature wne'r/ Lessee/cOnfrAfor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
'
STATE OF FLORIDA
COUNTY OF C e_
COUNTY OF
Swo to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
this �= day ofJJ i , 2020 by
this day of 2020 by
1C t'�) �'"� L� J ��Ll Yt(r "1r !1 E f ��Yt' •� r� I �� VGGd�
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 > L_
Produced
,PRY P&
Myrtle Norris
(Sigrigture of Not r(L4, iyStiExpires 04/21/2023
(Signature of Notary Public- State of Florida )
_11F IF II Commission No. GG 326189
Commission No.
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/2U
FPUA
OOx,11MUi',l'iTY PROUID
May 21, 2020
Kenneth & Anita Hibbard
2100 Elizabeth Ave
Fort Pierce, FL 34982-6488
Re: Water service for 2100 Elizabeth Ave
To Whom This May Concern:
Fort Pierce Utilities Authority
Customer Service
206 South 6th Street (PO Box 3191)
Fort Pierce, FL 34950 (34948)
Fort Pierce Utilities Authority's (FPUA's) records show there is water available to the address above. All
necessary fees are paid to initiate install.
If you have any questions, please call Customer Service at 772-466-1600 ext. 3900.
Sincerely,
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Chontae Johnson
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Customer Service Representative Ili
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Our mission is to provide our customers with economical, reliable and friendly 2038
�3 service in a continuous effort to enhance the quality of life in our community. 1 DL� I
Reliable Public / t11 WWW
Power Provider 772.466.1600 * www.fpua.com ST LUCIE COUNTY
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