HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / /] 02{ $�
Date:�8-3/�% (/� Permit Num er: �CC' ) v
0
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
PERMIT APPLICATION FOR:
rnLjruxu.nvrrnvvuV1L1*1 ,LUL-M UM.
JUN' ® 9 2020
rmittinrg De�jartment1
aentiblieC�lonty IZI
Address: -;--J• esc2 Ir Z i_ 3 `F Ct �a
Property Tax [D #: <RR ` C)oo Lot No.33�3
Site Plan r-�Q4t&-U,,4 oS Block No. a 6
Project Name:
�v_cg Clos-1;�C9 o QC:Q 5 ti car-n&-
C'as�l�c7 <�Cf- r.,: , 91-0 1 _f?%i1
New Electrical Meter
Second Electrical
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: O g'Si , ( r/erSq. Ft. of First Floor:
Cost of Construction: $ f Q Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE m
CONTRACTOR
_ .... .. _ ,.._ .:._..
Name
Name:
Address: 'Lf (J
Company:
City:-F:4 ;Q� �' State:;--7L
Zip Code-2 Lf T R a Fax:
Phone No. "7Z a ' 3 �r�O' S- "-I W X
Address:
City: State:_
Zip Code: Fax:
Phone No
E-MaiI,4t, K-v,cDCQ L ^�_ MS A. ct
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.
SUPPLE(SIIENT'AL-GQNSTRUCTION LIEN
rs
DESIGNER/ENGINEER:
Name:
_t•WNFORMON.,
Not Applicable
MORTGAGE COMPANY: ANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
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 holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or andcovenantsthat 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 fallowing 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 reeards 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 betore commencing worK or recorcling your Notice or commencement.
-'s Q )- zc='Z-S�—
Sign re of -Owner/ Lessee/Con ractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �24- COUNTY OF
SworD to (or affirmed) and subscribed before me of
P ysical Presence or Online Notarization
this I day of T fi n PO .2020 by
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this _day of . 2020, 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
(Signature of Notai Public- State o Florida (Signature of Notary Public- State of Florida )
Commission No. `•; AUDjtEY �. HUMPHREY
cx= MYCO ONSGG300817 Commissiga No.
de EXPIRES: March 6, 2023
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW