HomeMy WebLinkAbout20200713_Building Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services i
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: P�•�pOF/.t/G
PROPOSED IMPROVEMENT LOCATION:
Address: mos Cv2y CCGL
Property Tax ID#: ?/C/673--7�% —'97—
Site
Site Plan Name:
Project Name: _
DETAILED DESCRIPTION OF WORK:
�r%7-�F)y'e A.+�7 ��%LFJ-CE ��c/STi,✓ �p JY off ii�CL
tZ S.LL Tom! yl�/cT SuOoT� �T 519 vi�F2c.9�fNewi
-r 15iq yFTa➢L /?,QUI i V Cr2/.r(� ZG 6f� .
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION:
Lot No. / 6
Block No. G
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: / 3s 6 Sq. Ft. of First Floor: / 3 6 O
Cost of Construction: $ 013-3�20 Utilities: -Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR: j
Name -.T fJFI-d--� Zy H ,0-h O'Y
Name: .4J 1—
Address: 70,f- &4f°f /2c4
Company:
City: 7&4:L ST L , c c e V State: SGL
Zip Code: Fax:
Phone No.
Address: 3 !2!:3
City: 07- State: cc
r
Zip Code: 'l S' q 9f 7> Fax:
Phone No `77Z 7-Z
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail
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.
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NOTA
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DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name of person making statement.
Name:
Personally Known OR Produced Identification.
Address:
Type of Identifica 'on
Address:
Produced
City:
State:
City:
State:
Zip: Phone
Commission No. 9lF" FI ,e
-�n;�� ,' nded thrn Aaron No
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY:
Not Applicable
Name:
VEGETATION
Name:
MANGROVE
Address:
COUNTER
Address:
REVIEW
City:
REVIEW
City:
REVIEW
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 jobsite before the first inspection. If you intend to obtain financing, consult
-nr, n++^rnov hcfnra rnmmonrina wnrk nr rPrnrrlinu vnur Rlntire of Commencement.
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Signature of Contractor/License Holder
`Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORI A CC', Cc
STATE OF FLO Q
OF &
COUNTY OF -� t
COUNTY _ r
SVntc (or affirmed) and subscribe•, before me of
S orn to dor affirmed) and subscribed before me of
s
Online Notarization
Phy°sical Presence or Onlrn'e Notarization
this 4l day of 7,n1r\ 2020 by
Physical Preece or
thisIQi day of -_1p , 2020 by
fd
P../ 1'� /1CYi�-
(� �%� '� tic) 2"
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification.
Personally Known OR Produced Identification
Type of Identifica 'on
Type of Identification
Produced
Produced
ature of Nota yPublic- Stat&• r[ Commission # GG161
=*: -
�� `� ExDire s: November 16,
JAg"hatuise o y Public,, at �orida z
`'= Commission # GG161404
t=
November 1
Commission No. C C 6, 262
Commission No. 9lF" FI ,e
-�n;�� ,' nded thrn Aaron No
anded thru baron Notary
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20