HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: V 5 �J
Permit Number o5��-0-�-�
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6 2020
JUIN 0,
Building Permit Applicati I n�i- �. . .
Planning and Development Services f " '-lt 1 '-rn an
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Building and Code Regulation Division Commercial Residenttai �pL
2300 Virginia Avenue,Fort Pierce FL 34982 ---
Phone:(772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
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Address:
Property Tax I D#:--I�-3 C? -- (o Q -- Q�� - ��(�-- Lot No.��
Site Pian Name: I ak e l-kp E6:�a+e Block No. (T10-
Project Name: ti5aKn►e,, a-, Ute...
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New electrical Meter Second Electrical Meter
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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: _Tp� Sq. Ft. of First\Floor:
Cost of Construction:$ 0_0 , 6 D Utilities: —Sewer `Septic Building Height:
c .rx 1'i ,� k 7 �t''st � ''�{3a' Y s 4 :; 5 a�+�" y �t .:.#
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NamegnnotP, I I mc L2 Name:
Address: (a C 3 3 had eA Lzi ke, La n g , company.-
City
ompany:City: e)Y-: - ,V-Ce_ State: rL- Address:
Zip Code:. Fax: r 1 GC.,,� Cit
f y= State:
Phone No. r7aa Zip Code: Fax:
E-Mail: / 1 Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from-the Owner listed above) 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,
DESIGNER/ENGINEER: T 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:
OWNER/CONTRACTOR AFFINIT: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 buildingpermit 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 commencing work or recording our Notice of Commencement:
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P�
re Owner/Lessee/Cori-tractor as Agent for Owner Signature of Contractor/License Holder .
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
Swor o(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 of . ,20_ by this day of ,20_ by
lvnn e— J g
Na a of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Ideni cation Type of Identification
Produced L 1— Produced
(Signature of 9(tM Public-St too I (Signature of Notary Public-State of Florida)
AUDREY B.HUMPHREY
Commission No °= MMISSIO 4300817 Commission No. (Seal)
EXPIRES:March 6,2023
REVIEWS FRONT ZONING SUPERVISOR PLANS' VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.