HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r
Date:_ Permit Number:
Building Permit
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
n JUN 2 2 2020
PERMIT APPLICATION FOR: IZ' " Zp' %'01VS7-1214C7- 1OAJ
Address:
Property Tax ID#: i301-60S - 039Y 000- I
Site Plan Name: K1= 00b PAR K 61 N/%%- 5-
Project Name:
New electrical Meter Second Electrical Meter
Lot No. &
Block No. -5-6
Additional work to be performed under this permit -check all that apply: �/
_Mechanical _Gas Tank _Gas Piping _Shutters ;1 Windows/Doors _Pond
_ Electric _ Plumbing _Sprinklers _ Generator �C' Roof Pitch
Total Sq. Ft of Construction: 0 Sq. Ft. of First Floor:
i
Cost of Construction: $ !T .-7o o o , 00 Utilities: —Sewer _Septic Building Height:
OWNERR/LESSEE
:
CoNTRACTOR
Name
Name:-_. L
Address: IR
r>
Company: '
City:
Zip Code: _3L) 95) Fax:City:
Phone No. o - Z 2
_ State: EL
Address:
=�--• . •- -. , ,• 1'� State:_
Zip Code: Fax:
Phone No
E-Mail: : b L.4 S -rf- T F-R �i9fiDD. �O/Yl
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, aRECORDED Notice of Commencement is required.
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MORTGAGE COMPANY: _
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Not Applicable
DESIGNER/ENGINEER: _ Not Applicable
Name:
Name:
Address: `" `
Address:
City:
State:
City:
State:
Zip: Phone''
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
_ 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.
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 holderto 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
improvementsto 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
or an attorney betore
Agent for Owner
STATE OF FLORIDA
COUNTY OF' SXc • Lt 5�
Sworn to (or affirmed) and subscribed before me of
Physical Presence or _ Online Notarization
this aJay of vvf 20a.� by
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Produced F %_ bl--
(Signature of Notafy'Public- State of Florida
Commission No. �T O tti>K pftA�fMo 0( 82:
hrf S: DaceR�58, 2820
REVIEWS 1 CF NTER ' 'REVIEW I NING SUPERVISREVIEWOR
DATE
COM
ram¢ vour Ivouce of
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Physical Presence or —Online Notarization
this _ day of , 20_ by
Name of person making statement.
Personally Known
Type of Identification
(Signature of Notary
Commission No.
OR Produced Identification
State of Florida )
(Seal)
PLANS REVIEW I VEGETATIONSE REVIEW LE MANGROVE