HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �0 LA, Permit Number: Q00 1 y
- 0010
RECEIVED
Building Permit Application JUL a 8 2020
Planning andDevelopmentServices ST. Lucie County, Perrn(kring
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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 INtPROVEMENT L(JCA710N
Address: 5Q inn 1 rL_UGI,-P_ t61y 52.1 F9jeT i cece, ILL, b4g1/6
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPI"lON OF WORK
Pry \lac C2 QAJ 3 ;de,: O `O
New Electrical Meter Second Electrical Meter
CONSTRUCTION=INFORMAT(ON , Vi
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: Sq. Ft.of First Floor:
Cost of Construction:$ • � Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE G CONTRACTOR l
Name M41tq P,. Name:
Address:_aba,J �qi►i f" LLU'e- 614, 0548 Company:
City: 0 H P,e" State: R, Address:
Zip Code: -,3ggQe Fax: City: State:
Phone No. qoq-qOS- 00530 / Zip Code: Fax:
E-Mail: rd Mlq awfol( QMq//i G4/n Phone No
Fill in fee simple Title o`Idder`o/n 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.
I "
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION - _ #
E DESIGNER%ENGINEER: µ m Not Applicable MORTGAGE COMPANY: NotApplicaWett~ !
Name: t
Name: t.4;
Address: Address;
t°}City: State: City: State: #.
Zip: More Zip: Phone:
E SIMPLE TME HOLDER Not,ApplicableBONDING.COMPANY: _Not Applicable i tf
Name: Name.
Address: Address: . l
City. City:
---
Zip: Phone Zip: Phone
OWNER/CONTRACTOR AFFIDVIT:App#icaiian is hereby:made to obtain a permit to do the work and installation as indicated.,
I certity that no work or installation has commenced prior to the issuance of a pefmiL
St.Lucie County mattes no representation that is granting a permit will authorize the permit holder to build the subject itructwe
which is in.con id"with any applicable,Home Owners Association rules,bylaws orand covenants that:may:cesttict-or prohibit such
structure:Please consult with your Honte owners Association and review your-deed for any,restrictions which may apply. '.
;t
in consideration.of the granting ofthis requested permit,I do hereby agree'that t wig,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St..lucie County Amendments.
t..
The following building permit applications are exempt from undergoing a full cbnrurrency review:room addaior4. e
accessory structures;swimming pools,fences,walls,sjM,.scteen rooms and accessory uses to another non-residentW use
WARNING TO OWNER:Your failure to-Record a Notice of Commencetnettt may result in paying twice.for
improvements to,your property.A Notice of Commencement must be recorded in�the public records.ofSt.
Lucie County and posted on the jobs to before;the first inspection.if you intend'to obtain.financing,consult "
with lender or.an attomeybefore,coriimencingwork or recording your�Notice of;Commencement. _
i
Sikhaturle of 01i*ierl Lessee/(;d actor"'iO4ent for owner I Signature of Cdnt actorllxense Noldei _,.
` STATE OF FLORIDA STATE OF FLORIDA 1i
COUNTY OF t 1 (7 1 r-. COUNtYOF,.
Sworn to(or affirmed)and subscribed before me of Sworn to(or afro med)and subscribed before;me of
cal ceor Online Notarization Physical Presence or €?nhr*Hotistwation,
Zj t
this" d of W .2020 by: this, day of 2020 by f
Name 6f person rnakih statement. �, p I Name of person nuking statemenL z
Personafty Known ORProduaed tdentification Personally Known OR Pf oduceld ; hi: vsiir c ,
Type of Identification Type of IdentiftAtion
Fj
roduced__� Produced
( ignature of Notary uWic-Sea i(if Florida) § l5rgnatum ofi*nt a +
Commimion No. (seal) ,;r:rrtmrss t its,
3 s v r
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