HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST'B COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� Permit.Number:a`.oJo—?
RECEIveb
JUL 10 2020
Building Permit Application
Planning and Development5ervices ST. Lucie County, Permitting
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)4.62-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: Veroo
R
Address: h
D
`Property ProP e Tax ID#: 1 . Lot No.
Site Plan Name: Block No.'
Project Name:
New electrical Meter Second Electrical Meter01
-
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:$ 'O®,vo Utilities: _Sewer _Septic Building Height:
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ME
Name or Name:
Address: n Company:
City: tp-r— State: L Address:
Zip Code:' 6 L Fax: City: State:
Phone No. `L757 3 ` Zip Code: Fax:
E-Mail: 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. /�
DESIGNER/ENGINEER: �Not Applicable MORTGAGE COMPANY:. —Not Applicable
Name: Name:
Address: Address:
State:. City: State:
City: • Phone:
Zip: Phone zip: --
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 consultwrth-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 concunency'review:roam additions,
accessory structures,swimming pools;fences,walls,signs;screen rooms and.accessary uses to another non-residential use
WARNING TO 0.WNER:Your failure to Record a Notice of Commencement inay 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.'lfyou iritend to obtain financing, consult
with lender or an attorney before commencing-work or recordin - our Notice of Commencement_
Signa ure of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder .
STATE OF FLORIDA. STATE OF.FLORIDA
COUNTY OF COUNTY OF
Swornp(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Pcal Presence Online Notarization. Physical Presence or Online Notarization
this day of 20 this day of 20_ by
l CJ Name of person malting statement.
Name of person m dn-g statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of ldentificatio Type of Identification
Produced �- Produced
i
(Signature of Notary Pu lic-State of Florida). (Signature of Notary Public-State of Florida)
Commission No. .�������� KAREN S(SWOLSEN Commission No. ,(Seal)
=o- ;State of Florida-Notary Public
_* *c Commission # GG 207484
OF f,``` y une 12, 20 2
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