HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE.COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7A Permit-Number:
JUL 13 2020"
Building Permit Application
Planning and Development Services ST. Lucie C linty, 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:
Address: / Dla(;dAlj6 roz� &-nen' F4
Property Tax ID#: `�a���b �ad a- oda -� Lot No.
Site Plan Name: Block No.
Project Name:
Meco
art
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 _ tt�—� rinklers _Generator _ oofrZ. Pitch
Total Sq. Ft o nstructioni q. Ft. of First Floor:
Cost of Construction:$ Utilities: Sewer., Septic "` Building,Height:
+�.' "1Vr R�-}�` 1y T .r•. ''�7r �" .c"+Tu{, ':�,ti:«•-4 .�^��u�- -�y -c> -•..•-'��"_caL' �`.� ":�'T``,�"��'r�s�"
a 'k...'_ __°!. +x� .•�� .a w•n. .:=_Yz-,. _.i:rr:. ,:3*-if'i:L6 :n. 'EFrz.'•.. r` �kk.7�': :�a+ ..s :.�.5'e+ .. _.e�Ca..3._s.-rwS -
Name. SwA& P Marne.:.
Address: Z`•>:.
c2 D � � Company: -
City: - o te,.II State: Address:
Zip Code:'t A 7_ Fax: City: State:
Phone No.3 Z (2.1 Q/ff Q Zip Code: Fax:
E-Mail: C,.l ; ( U om ` l 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.
i1 ,
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEESIMPLE TITLE HOLDER: Not Applicable . BONDING•COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFOVIT:Application-is hereby made to-obtain a permit to-do the work and installation as indicated.
.i certify that no-work.or installation.hat commenced prior to the issuance.of a permit
St.Lucie County makes no representation that is,granting a Permit will authorize the permit hoideito 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 Assodation and reviewyour deed far any restrictions whrch may apply:
In consideration of the granting of this requested permit;l do hereby agree that I•will,in all respecfs,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,watts,signs;screen rooms and.accessory uses to another non-residential use
WARNING TO 0W NER:Your failure to Record a Notice'of Commencement may result in.paying twi;e.for
Improveme.MS 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 lepoergir aylattomey before commencing work or recordifigyppr Notice of Commencement.
Signat e pbwnW Lessee/Contractor as Agent for Owner Signature"of Contractor/License Holder .
STATE OF FLORI STATE OF FLORIDA
COUNT -'OF COUNTY OF
Swo/n to(or affirmed)and subscribed before me of Sworn to for affirmed)and subscribed before me of
Physical Presepcg o Online Notarization. . Physical Presence or • O_nline Notarization
this day of 20_Qby this day of .20_ by
Name erson making statement. Name of person making statement.
Personally Known ✓ O Pon_• Personally Known OR Produced Identification
Type of Identificatio ° JOSHUA pERTES Type of Identification
of F10 da
��_ !+o a ion GG 75728
Expires an 16;2022
(Signature of Nota is State of PYbrida (Signature of Notary Public-State of Florida)
Commission Ni
(Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
a