HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
.LU E
COUNTY
F 'N p R I E) A
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Residential
PROPOSED IMPROVEMENT LOCATION:
Address: 12:)N Ma (sh 'f2 (CGr p
Property Tax ID#: Zblk - 94n4 ' 06L1,'!S- 086- b Lot No.
Site Plan Name:Block No.
Project Name: 14 of nA
DETAILED DESCRIPTION OF WORK:
f n >�Vo so
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 Plumbing _Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: Wvcde Gf�'be
Address•'i3�L1 x(61. �.
Company: Ln M�* NAAahlo\nA
City: Vh( Ae (AtE State:kL.
Zip Code: 3�19� Fax:
Phone No.
Address: 3ntn6t--A R d.
City: r. C kMStater(
Zip Code: 34gLfS Fax: -Y)V k 1 I- I `5qC
Phone No 112 - 4 I. ( (1 69
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail 1 4 amaw
State or Coun y License 2.V °1 1
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:
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
STATE OF FLORIDA
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
Name of person making statement.
Address:
City:
Personally Known \*< OR Produced Identification
City:
Zip: Phone:
Produced
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.
Inconsideration 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 IPndPr nr an attornev before commencinE work or recordine vour Notice of Commencement.
Rev. 5/6/20
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
1 ' �
COUNTY OF � VNi
COUNTY OF
Sworn 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 L dayofane 2020 by
--K
this 2 day of &yI,& 2020 by
Name of person making statement.
Name of person making statement.
ng
Personally Known A OR Produced Identification
Personally Known \*< OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- Sta^lWall
o Notary Public- State of FI
yrs+ otary Public State of FI
Commission No. e$}in Marie Lovejoy
Ida
Com Isslon No. Nota"Ilt State of Florida
Erin Marie
�j p• My Commission GG 355
IN, nd� Expires 07/16/2023
3 Lovejoy
• My Commission GG 355643
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
A
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20