HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE C011 ,--;rED FOR APPLICATION TO BE ACCEPTEL`
Date: S-3/-2620 Permit Number: Z006-001y-
�40 RECENED
Building Permit Application JUN 0 91010
Planning and Development Services Permitting Department
cie County 9(
Building and Code Regulation Division Commercial Residential St. /1
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: &sweg iz , RESMDEN-171L I
Address: JUb UKIDLEW00D WAY WX VIEBCE1 FL 3JIYYYO
Property Tax ID#: 2-°Jn-L112-Ob00- w-:3 Lot No.
Site Plan Name: Block No.
Project Name: kiyriwy)a
DETAILED DESCRIPTION OF WORK ,
7RAWrtk SWZTC14 ON PRE -CAST PAO
New Electrical Meter Second Electrical Meter
s
CONSTRUCTIONINFORMATION: - — -
Additional work to be performed under this permit— check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _
_ Electric _ Plumbing —Sprinklers X Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
_ Windows/Doors _ Pond
_ Roof Pitch
Cost of Construction: $ J46 L 0 Utilities: -Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR':
Name E.
L 2
Name: OWNER
Address: 50 BRIOLEY1000 WE
Company:
City: gnRT P=aCE State: FL
Zip Code: -71 q q Ll S" Fax:
Phone No. 27 2 - S/ 9- 833 7
Address:
City: State:_
Zip Code: Fax:
Phone No
E-Mail: iT i rho bi I es 929 92 a In41 I . coir%
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail
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.
SUPPLEMENTAL.CONSTRUCTION LIEN LAW;INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY:
Name:
X Not Applicable
Address:
Address:
City: State:
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY:
Name:
_4Not Applicable
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.
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 attornev before commencinga work or recording vour Notice of Commencement.
t
Signatur of caner/ Lessee/Contractr s Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDAS4 1 , . Cl a
{
STATE O FLORIDA
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 _affyd—ay of A 4 .2020 by
_
this _ day of 2020 by
gM�
% AMES FJ�L�C :�L_
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
Produce
Produced
. �µ:=:Y"•• JILLL.ARNOL
(Signatury of Notary Public- St _ pf R TYCOMMISSION#GG 1244—sig
ature of Notary Public- State of Florida)
EXPIRES: July 23,202
Commission No. �IZr% i '"•`.i"3 Thru Notary Public Untle
fission No. (Seal)
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ev. 37672U-