HomeMy WebLinkAboutBuilding Permit All APPLICABLE) INFO MUST BE COMPLETED FOR APPLICATION TO-BE ACCEPTED
Date: !0�1� Permit Number: 900L —op 0
R } - JUN 1:5,2020
permitting Department
• St.Lucie county,
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR
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Address: D 7o Al / I cll Unl t q0-D Hul ClnSan FLJ0
Property Tax ID#:��d��J [�,�� C�(�"I�� 8 Lot No.
Site Plan Name: Block No.
Project Name: V(�
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New electrical Meter Second Electrical Meter 3
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Additional work to be performed under this permit—check all that apply:
_/Mechanicalas Tank _Gas Piping _Shutters _Windows/Doors _Pond
V Electric Plumbing _Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: 1500 Sq. Ft. of First Floor: I,500
Cost of Construction:$ I'D QQ1) Utilities: _Sewer _Septic Building Height: Y Poor-
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'`.Name fvC 5 Vk Gr -'4 kms � l�, Name: &Ul Lk-
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Address: ��70 /V 'it1`V.0 a' A -A up &25 CompanCPA) 1c,I C
City: 8U kQr\,50� S 9�� State: Addressr:- 'p;J "5 2-q IAA-::S
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Zip Code: �H q,q Fax: City: Fig 7.:�`(
C, State: �—
Phone No. �O`,),__q (0 0 "1�7`? 3 Zip Code: 3-11 q°�7 Fax:
E-Mail: i( i C tlt l( lw I CCDM Phone No
Fill in fee simple Title Holder on next page (if different E-Mail C{wC e 5 4A a I(�Ino h( ,C9h
from-the Owner listed above) State or County License CbC l a(o` go q
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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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 AFFIDVIT:Application is hereby made to:obtain a permit to do the work and.installation as indicated.
fcertifythat no work or-installation has commenced prior.to the issuance ofa 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
improvement s,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.commencin work'or recording ur 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. 5 w, yi "�� 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\5 day of -4 J nt' ,20 1%4 by this C-%day of ZS.a•nsr ,20_jj�Loby
e-i Qd.J \•a � ���aL�
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 !Z .L J�s.c- Produced f) 1L
17
(Signature of Notary blit-State of Florida) (Signature of Nota Pu t ite Qf Florii�a) tr Cj to
1023
Commission No. C 4Z 65 (8SAPAMARIEGIVENS Commission No.
k My commis ON#GG 022023
V EXPIRES:December 76 20 0
WrIded Thru I lotary Public underwdtera
REVIEWS FRONT PLANS VEGETATION SEATURTLE. MANGROVE
COUNTER REVIEW REVIEW REVIEW_ REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.5/6/20