HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO.BE ACCEPTED
Date: Permit Number:
LUCE� I Y.V P
o JUN 2.2 2%,10
- _MR-01WIK- Building Permit Application
Planning and Development Services ST. Lucie County, Permitting.
Building and Code Regulation Division . COn1me' ,'Cial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:
Address: I06o' Arlt AQt,e�l� ltann2• 4, �r-�'e 3 y /tIS-
Property Tax ID#: ;231 -2 o2- oo2$. 0-00-4 Lot Notr
.
Site Plan Name: �!P M mi3i s f*-"c ie- Block NoVn
Project Name: 'T�w,r►,oz,S=
D A LED DESC�R4IPTIO U W4R
To rbs 1-,a.11 33) ,a of Vim Y/—lsr=nce
41so "'UII I-4-3-'Fr DF Vt tV Lt"T&II WC+h Q pw81e- �t fzTyW-9)
New Electrical Meter Second Electrical Meter
CON- U C� INFO ATID :
Additional work to be performed under this'permit-check all that apply:
_Mechanical _Gas Tank —Gas Piping' Shutters 'Windows/Doors. _Pond
_Electric _Plumbing' _Sprinklers _Generator ='Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:-$ O ' Utilities: _Sewer _Septic Building Height:
O N f MMS �E• CO T ACTO
Name -at -Ti'Ywmc,tS ILitt de, ani n; pame:
S' P LE ENTAL +NS7RU N L N LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: �,� o� Address: �k vt
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:_ `I (/ Address:
City: I�N City:
Zip: Phone: 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 fan attorney-before commencing work or recording yourNotice of CpVmencement.
Sig ature of caner/Lessee/Contractor as Agent for Owner Sign tura of Contracto icense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFSir• COUNTY OF ire
Sworn to(or affirmed) and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Prese ce or Online Notarization Physical Presence or Online Notarization
thisa-a day of �y�� 2020 by this a.Way ofy v1? 2020 by
T 01-
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 V d L
(Signature of Notary blit-State of Florida) (Signature of Notar Public-St S
NAMARIEGNEN
Commission No a MARIEGNENS �,,.... DEQ? 0 GG 022023
Commission No.� ] ��:° 3MYCOMM�16.2020
jS,.••. MYM SION#GG 022023 , yr, �tPIRES: tats
i f: ��*" F�CPIRES:Der 16,2020 S. �: P00 Under O
ars -�' i- or dedThN NotatY
son
REVIEWS FRON 596PEMRVISOR PLANS VEGETA SEA TURTLE MANGROVE
COUN R REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.