HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO-BE ACCEPTED
Date: Permit Number: -
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JUN 1 0 2020
Building Permit Application I
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Planning and Development Services
Building and Code Regulation Division Commercial Re5ld:ential_✓` _�
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772Y462-1518
PERMIT APPLICATION FOR
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Address: gJYI�C� �JL',CI�I!
Property Tax ID#: ;(3()q-So 03q 0061 S` � Lot No.
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Site Plan Name: W � F0(+ ceCZ� eS P`C1+ i A 9 35 3�f'S %Z Block No.
Project Name:
"'[����.�'������ �� -F+.d„a..:c���..•�,,.-�4i��c,e��'F.«,�wa"�+Si�"`.'-4f'a aced.-n�:fa�.. ?.'9+k,� �'a1�"��"�o-'-;.�',- �� 5-Iy" ��-'�' {' ..=rwke..�,�.krl,.�..3.-��k+.-�4;^.�._. ':ams,;.
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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 V/ Generator —Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ y Utilities: _Sewer _Septic Building Height:
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Name 7` - Name:
Address: q51 l MP_(_0dC RV0511,_'Q_ Company:
City: f'P f-("e State� Address:
Zip Code: Fax: City: State:
Phone No. `7 7,2- Ste/®-,_� 65'7 Zip Code: Fax:
E-Mail: O f` Q G-N+Oef 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.
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SUP LEM t .p SRU T ON'LUEN Ri�iA
DESIGNER 9NGINEER_;y' _Not`i4pplicable MORTGAGE COMP�INY:;• _ Not;Applicable. .
Name Name
i Address Address _
state ' city
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State
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FEE,SIMPLETITLEHOLAER NatAppUeable 130NDING;Ct)MRANY _Not.Applicabte �.
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Address; .:. , .., . Address,
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Zip: PhZtp Phone
OWNERf"CONTRACTOIC FIDV,IT Application ishereby made to obtain apermit to da fhe-work;a id instaltati4n asrindicated
1 certify that r(67,work or installation has:commented prior3o tfie issuance of a O�dt,in
Sfi Lugg Couri makes no reEi esentation thatsis granting a ernit will authonze.the emtit holder to build the;subject stru%ture
irvhi Ei^�s in�coti ict vuith any.appl'icabte>Home Owners AssoE at bn rules,:bylaws or and co_v,"eriants that may:restFic A6f',0r6h!bittsuch:
structure PleaseconsultHnthy,our=i♦omeQwnersAssociaUonartd'review-your,deedforany;restrichonswfiich.mayapply.=
F In consideration of the granting of this requested permit,I do hereby agree that(::wilt,Insall respects,perform the work A.
ccordance vuith„the approy'ed plans,,the Florida t3w(ding Codes find St in
e
LuatCoun Atnendmenfs tY - i
Thafgllownng',buddingpermitapplicatiorisare exempt;from undergoipg;a full concurrency raw -;r,00m additions,
accessory structures,swirriming pools,,fences;.wtalls,signs;=screen rooms and apcessoryu'ses to arotherrion reside°ntlal use
WARNING TO QWNER Yaur failure to,Record a Notice of C®mmencement may result`in paying twice for
Amprouem. is to you> property A,Notice'of Commencement must be iecorded in he public records of St
Lucie Co and ostetl ontthe jobsite before the first inspectwon If you intend to'oktam financing;consult =
uritti er.or`` .attome' before co nmencin ,work,orr`ecordirt our,.Notice°;ofCommen cement:;
i
Si of OwnerJlessee/Contractor as Age»t for Owner Signature of Contractor/Ucense:Holder j
STATE`OF ELORID`A STATE OF FLORIDA
COUNTylOF
�-cCC.r�= COUNIY OF
Swo to(or”"affirmed)andsubscnhed before me of Sworn to Ior affirmed]and subscnbed.before fine of
Physical Presenceor Online Notarization: Physica!'Presence or „ Qnline Notarization
this day ofLt day.,of: 2020 Eiy
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Narne of arson making statementT Name of person;making statement.
PersonaAy'Known i� OR Produced Identrficatton Personally Known OR Produced ltlentificatton-
..{ Type of identification Typeof Identification`
P'... uc d" Produced
{ (Signature of,p6tayPURIC, tea da .` SHARON DEfi ORIO {Si` ature of Notary Pablic State of Florida)
`_ NotarylPubiic State oGF onda�`
Co[rlmissiori:.Nq. 5 `= `�seaJQommission#6G o4t 7fw fission Rio (Sail],
MypGamm Eiipif Oct 24 2020 '
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PREVIEWS,- -FRONT.V ZONING SUPERVISOR;; PLANS VEGETATION SEATU'RTLE MANGROVE::. i
',- COUNTER REVIEW REVIEW "= REVIEW REVIEVI/ REVIEW, REVIEW-
{{ DATE -
I RECEIVED
DATE
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