HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �G a,.a aO
Permit Number: a"Odr"'d5gJ
RECEIVIED
Building Permit Applicatio JUN 2 2 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: ac S
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Address: �U08 Pcn„ ��nc F� I� ucc F� 3t1951
Property Tax ID #: Lot No.
Site Plan Name: 1301-6//-6/8S-600-J Block No. IN
Project Name:
New electrical Meter Second Electrical Meter
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� 6 A Sq. Ft. of First Floor: A10
Cost of Construction: $ 9-ow.00 Utilities: _Sewer _Septic Building Height:
0W0ER1LESSEE
:
CONTRACTOR.°-
Name 7—ommy
Name
Address: )DOY Pr-nny Irma
Company' =°
City: `i Retec Stater
Zip Code: 3 J(W Fax:
Phone No. i22-370—GVII '
Address:
City: 7 = State:_
Zip Code: Fax:
Phone No
E-Mail: /-�rn� e_+1Wle1 G l- 1V
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.
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 Counttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
bylaws that may restrict or prohibit such
which is inconflict with any applicable Home Owners Association rules, or and covenants
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 attorneybefore commencingwork.or recordingour Notice of Commencement.
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pl�ltillEV�NDESIGNER/ENGINEER:Not
Applicable
MORTGAGE COMPANY:NotApplicable
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:
SignaturOwner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTYOFQc,�
COUNTY OFSworn
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
�h—i�"�dayof50v�C20'� by
thisday of 20_ by
rb.-1-�Name
of personaking statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Producedt—
Produced
(Signature of Notary(Signature
of Notary Public- State ofFloridap�I,ipE
GN�NSSIGN#G0022023
CommissionNo.