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Building Permit Application
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED c� Date: Permit Number: 21ro [LUCE, RECEIVED Owpm Building Permit Application JUL o 2020 Planning and Development Services ST. Lucie County, Permitting 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: PROPOSED Il�tl�t?#tOVEMENT LOCATI• N. Address: [OP- QUO Al e)[ o{ �'-� F.. 34ef �5 1�ES Property Tax ID#: 34,CA ^ 0 5 s " 00,0 1 CO OJ 77 Lot No. I Site Plan Name: Block No. l Project Name: DETAILS© DEC•R)PT10N OF WORK: New Electrical Meter Second Electrical Meter CONSTRUCTIONI IN1F10M,ATIONA, 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 X_Roof "- Z Pitch Total Sq. Ft of Construction. 2 q�Jc Sq. Ft. of First Floor: Cost of Construction:$ Zr -� �""4 Utilities: _Sewers"' , ,SePSti�, Building Height: OWNER LE5,SEE: C® RACTOR. .Name -O Nat ce- ' Address: t0,1� K u (_Wcp� V�? vo Compa"ny: City:_ State Address`. :fFt. Zip Code:34-9 Fax: �' � ��� City: r' State: S( n 41 Phone No. J� l ``��=2 e Zip Code:`'�rf. j ;; Fax: E-Mail: 'Da 0 Q f`� ,(,`Lim @_ytC) MUT I Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) 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. SISPPt MEN AL CONSTR NI0 LI E N LAW CN �©RMA !ON• 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. 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 beforVo-mmencing work or recording our Notice of Commencement. Sign at re of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA 1 �I STATE OF FLOR14A COUNTY OF LJ- COUNTY OF S'1 /G' Sworn to(or affirmed)and subscribed before me of Sw to(or affirmed)and subscribed before me of _Physical Presence or / Online Notarization to Presence or Online Notarization this t1, day of�L C, 2020 by this_day of e!5 2020 by Name of person making statement. Name of person making statement. Personally Known OR Produced Id tfication Personally Known OR Produced Identification Type of Identification \\``11a11�1i#011%� Type of Identification Produce pg� Ee/i �ii� Produced (SiRriAure of Notary Public- e*of Florida W 40 •;*s (Signature of Notary Public-State of Florida) Commission No. o Seale -,-. - Commission No. (Seal) ST TE ����� REVIEWS FRONT ZON�I Gi11101S�rERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.