HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: - %% C-P C) Permit Number: -o 56Q
RECEIVED i
JUN 2 3 2020
R Building Permit Application ST. Lucle County, Permitting
Planning and Development Services
Building and Code Regulation Division Commercial Residential Jt
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR >
Address: ' SJ'�O / leo h AyEr R` f ierc2 44
PropertyTaxlD#: ��d�-���'O�a.�-000'i Lot No.
Site Plan Name: Block No.
Project Name:
New electrical Meter
Second Electrical Meter
I'CoivSTRUCTION'INFORMATIONa xp ." .._
Additional work to be performed under this permit -check all that apply:
_Mechanical
?(- Electric
_ Gas Tank
?'Plumbing
Total Sq. Ft of Construction: -3Cx:�
Cost of Construction: $ )Ua
—Gas Piping
}[Sprinklers
_ Shutters
Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof
Utilities: _Sewer _Septic Building Height:
Pond
Pitch
OWNER/LESSEE:
'.GONTRACCOR
'
Name iinri A' ol'Ll nn
Name: bran KI
%� /i Avn
Address: .SSSO / ,Qle /PAh
Company:
fn 7L'er ri -e
City: State: tL
Zip Code: 3 W 4YX7-bCity:
Phone No. iC/( - cj�t36- dcpsS
Address: s
Zip Code: ; 9i fF
Phone No �C
State:/_G[ -
i Fax:
-
E-Mail:2S
Fill in fee simple Title Holder on next page ( if diffGerent
from the Owner listed above)
E-Mail Jh /d /'h.iiry ¢wi r%r es- e/d Al
State or County License 'FL STATP Ll r P
c s
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.
ENTAL G0 . STRVCTION L'15N'LAW.INFORIVIATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name•. Name:
Address: Address:
City: city.
Zip: Phone: Zip: Phone.
)WNER/ CONTRACTOR AFFIDVIT: Aoolication is herehv made to nhtain n nermit to dr. thn l.rr.r4 �..a
I.certify that no work or installation has commenced prior to the.. issuance of a permit.
St: Lucie Count( makes no representation that is granting a permit will authorize the permit holder to build
In consideration of the granting of this requested permit, I doherebyagree that I will, in all respects, perform the work
in accordance with the approved plansithe Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exemptfrom 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 Commencementmay 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 attornev hofnre rnmmanrino uinrlr nr rnrnrdinn ..nr.r n;,.+;,-
e-:: cu4J A 7-9-ao
r � 7-R-ao
Signature of Owner/ lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OFmFE9RfB t
D
COUNTY OF WQ, a 6-.
u
STATE OF,FLOR
COUNTY OF -
SWoyerto:(or affirmed) and subscribed before me of
✓✓
Sw fn to (or affirmed) and subscribed before me of
Physical ;Presence or Online Notarization
this;Q?^ dayofSu
/ Physical Presence or Online Notarization
2020 by
this 5!2 day of'.�LI.-I 2020 by
�cr:nk •tr.y....
Tta..�. •M M+v..
Name of person makingstatement.
Name of person making statement.
✓
l
Personally Known OR Produced' Identification
Personally. -Known OR Produced identification
,Type, of Identification
Type of Identification
Produced
Produmd
(Signature of Notbky P lic- State of Reg& ) t+,.3wt
iVo: SF+ RieterT awl.@[)sr�r.^tr'•
(signature of Notary Public- St
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REVIEWS.
FRONT
ZONING I
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
I
RECEIVED
DATE
COMPLETED
I y .