HomeMy WebLinkAboutBuilding Permit Application Hu mrrLn,AbLt iNrU MUat tst WMPLt1#U FUH APPLICATION'TO BE ACCEPTED
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Date: �a Permit..Number6iD�
Building Permit APOR ti n JUN 32020
Planning and Development services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Comm' el'Cial - Residential
PERMITTYPE:
TtUN-
S
Address: (
Property Tax ID#: �4 I 0 – S 6�' �.Q .�p ® Lot-No
Site Plan Name: Block No.
Project Name.:. . .
IJ-TAIi.E► aESC�tPT'#t3N O iNOR .
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Additional work to be performed under this permit-__check all that apply:
_Mechanical —Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Lf v
Cost of Construction: $ Utilities: —Sewer _Septic Building Height:
Name 0 11(' G� �4 if n is Name: @gbk6 t fm 'C.L,/l S
Address: 6 S Ff 1' C 1 Company: m�
City: State: ' l Address: ?,31
7,3 1 �!�i4
ZipCode: C Fax: City: ♦ StLa✓te '7
51
Phone No. �d gSq ' State:
Zip Code:., 6 c?_ Fax: 22P
E-Mail: Phone No—,7 29
Fill in fee simple Title Holder on next page(if different E-Mail c i G �
from the-Owner listed above) State or County License 1'k A1�a
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice.of Commencement is required.
101 115 i :Mffl!
..
DESIGNER/ENGINEER: ____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 AFF16VIT: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 commencing work,or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder .
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF b �- , lac��. COUNTY OF 'Sar
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'4."'.s day of3_��� 20 a d by this --'�•3 Iay of J%3 hk 20 as by
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 '1- ib t— Produced
(Signature of Notary P lic-.State of Florida). ature of N -- —
" J"", DEIWNAMARIE. NS
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Commission No.��s d2. aNY"..,, D�iNAMARtE#Go ®m ission No -�. .• f` MIS �IRM N GCtyl;
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ber16, ZS ='. o:'°p�=' BondedTiwNatatY?ublicUnderwrsttors i
REVIEWS FRONT CS R PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER' REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.5/672