HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COME -LC I ED FOR APPLICATION TO BE ACCEPTED
Date: lD - 2 ^ 2020 -,a -9 ��% Permit Num
4(1111
�` ° Building Permit Applicat
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: MAST E r� VA-VK RtFIr100lf L
PROPOSED IMPROVEMENT LOCATION:
JUN ®? 2020
in
Permitting De Prtment
sidentijlci ounty, FL
Address: 6I158 I-ZiveZ i3E),40 L.AWe
Property Tax ID#: 1gV1 -• 501--•0023 -000 -!0 Lot No. 2-0
Site Plan Name: BAr\/ 5'T• L-U (-l1E Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
I\E j7)ALL ALL 7-01 1 1-4 t3 lk 1 H ROOM — RC- PLALL VANr)) ES
Z1 0'JLACL 6 u G
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical
_ Electric
_�GasTank
V Plumbing
Total Sq. Ft of Construction: .3+0
_Gas Piping
_ Sprinklers
_ Shutters —Windows/Doors _ Pond
_Generator _Roof Pitch
Sq. Ft. of First Floor: 3 5 00
Cost of Construction:$ 22,O0p.e0 Utilities: - Sewer, _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
-
Name L SIJLF ;4- DOtloVAN
Naaee: D POULtM
CONST'�Ikoc-' 1ORl
Address:_/2L88 I�IVLCJ131:N17 ! f3d/
Company: DAyir>
h1 P61L'N
City: Pr);?i ST L-uLiC. State: LL
Zip Code: 3 `F°I $ 4 Fax:
Phone No. 30 2- (D 70 -'+89 8
Address: &-'+S SE
MOVJf Rt �/ )for+P
City: State: �L
Zip Code: 3 49 cl 4 Fax: 77 2 -2 0 7 -l032
Phone No SO2Io- ID05-2
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Maildpolj(i LOroS T I?UCI-i Ot4 C' c-OM vYSb
State or County License CBC- 12.551o9
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
EER: ✓ Not
MORTGAGE COMPANY: V 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 concurrencyreview: room additions,
accessory structures, swimmingpools, 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 attornev before commencine work or recording vour Notice of Commencement.
I/ li
1 1 4 }ten V
Signature of Owner/ Lessee/Contractor as Agent fo Owner
SigKature of Contractor/License Holder
STATE OF FLORIDA
('n
STATE OF FLORIDA
Mnc���
COUNTY OF
COUNTYOF
Swop to (or affirmed) and subscribed before me of
r affirmed) and subscribed before me of
SwNlhi
✓ P X cal Pr Bence or —Online Notarization
thisayof_ 2020 by
_al Pres nceor Online Notarization
thiyof 2020 by
,.
Name of person making statdment.
Name of person making state nt.
Personally Known O,R Produced Identification ✓
Personally Known OR Pr uced.Identification�'
Type of Identificatio ))
Type of Identification
Produced f I LtOeN�_e
Produce
(Signature ublic- State of Florida )
(Signature of Notary Public- S t Iof Florida )
Commission No. INGTON
Commission No.
f„,yk�„, JAMI
R GG 156944
;RlV:•-„ JAMIEPENNINGTON
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:P,1' y GOMA9SS10N
; M SSION 1i GG 158944
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Rev.b/b/ZLI