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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �_f ICJ Permit Number: " C7`�O ? 01-5 9 017 JUL 14 2020 - - - _u- Building Permit Application ST. Lucie C unty, Perrnittin Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 PERMITAPPLICATION FOR: C Address:-76G1 '8a_,4v-'r- _54—., �k pl--jre , TkL 31141?1. Property Tax ID#: y��' CP� / ' �© (1 g ©®� Lot No. Site Plan Name: Block N.o. Project Name: New Electrical Meter Second Electrical Meter— R,1109 ATION: 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: t7WNE RM @ E•S�SEE: W,N ACTO Name (ci Name: Address: 70°I i"Ib", si- Company: .-_ City: T-(1 State:T�._ Address: Zip Code: 3LtA4L Fax: City: 7 7 State: Phone No.7"Jl�' �L�� `l�l Zip Code: Fax: E-Mail:KL-� ti J I g cQ Gy'Lv-'t C��� 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. i SUPPLEM �N1'AL C(�NSTRUC7;ION LIEN LAW 1 URMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: 41xot 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 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 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 jobs.ite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. Signa re of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA } STATE OF FLORIDA COUNTY OF I�'J ff, COUNTY OF Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed) and subscribed before me of Phivsical Pre nc or Online Notarization Physical Presence or Online Notarization this day of 2020 by this day of 2020 by Name of Berson making st tement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification I' Type of Identification duced Produced (Signature of No , - q IELSEN (Signature of Notary Public-State of Florida) \�4PRY PU" ;State of Florida-tt��,,otary Public Commission No. _� missio($�adG 207484 Commission No. (Seal) o„o My Commission Expires "7,�"` June '12, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.