HomeMy WebLinkAboutBuilding permit app All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED,
Date:- �'��'? iC� Permit Number: �(5
t
17
Building 'Permit Application
Planning and Developo»ent-Services
Building and Code Regulgtio n D+vision C:OT1'ttTterda"l Residential
2300'Virginia Avenue;Fort Pierce FL:34982'
Phone (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:'
Ct 1--K is t _(- L I fice
} F,k 0`SEQ tM 0,90V0111ENT LOCATION:
Address: - Pre1 `y" LYJ Eo. r4 i f ss -°t�
Property TaxAD.##:. �`� ��`.a �� � r L ���.� Lot'No.. '-! ca �
Site Plan Name: Block No.
Project Name:
DETAILEE3' DESC I TI;ON lAtORK
\�� I Sin 1 -
4 ~ram 1 er\1 0011c cg oy
New Electrical Meter Second Electrical Meter
'O( " TRUCT#Qi tNFC RWA, l( tV.
_-
Additional work to:be performed undeit this permit=check`all that apply:.
Mechanical _Gas.Tank Gas Piping _Shutters;.-:, = _Wiridows/Doo.rs _Pond
Electric i Plumbing Sprinklers _,Gener.at.or� Roof Pitch
Total Sq. k of Construction: Sq. Ft..,of First Floor:
Cost of Construction:$- 2_`�350 Utilities: _Sewer. °Septic Building Height:
l OWNER/LESSEE: G ?i�OTRA
Name a`3 ;� 1Iv1 lariie:
Address: SV —_ Company.
City:, State:i=� Address:,
Zip Code: £' - Fax:. City: State:
Phone No. _!.}" ( - '
t � Zip Code: Fax:
N-Mail:—lj '' t +f I a rti I 1 � ��htl � 'Phorie.No j
ilt in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above} State or Comity License
i
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
SUPPLEMENTALHCONSTRUGTION LIEN LAV1/J'NFC?R'MAT10N F
. MORTGA
. Ll;ESiGNER" ENGINEER _Not+Applicab{e GE COMPANY: Not AP licabie:
Name; Name: -
Address: .Address
_
Cray: State; Crfy State;
i
Phone Zip: Phone:. i
FEE SIMPLE TITLE'H4LDER; _Not. p jicable, BONDING COMPANY: Not App(rcable
Name: Name:' ;
Address Address;
city I City:
{ Zip; Phone::, ! Zip: Phone.:
4.
OWNER/CONTRACTOR AFF!D.VIT:Application is herebymbde to obfa n a;permit ta'da'the work and;instailAdwas indicated.
I certfy that no work or<ins Lallaton hareommenced-priorto,the'i5suance of.a:permit
Sfi:Lucie County makes r o representation that:�is.granting:a-permit,will authorize the'permatholder16 build�fhe.subjectstructure
which lsin conflict with any,appli;cafjle f•lome Owners Associatiori,rules„bylaws or and:covenants that may restrict or pro., such
structure.'Please°cansultwath your Horne.Owne sAssociation,and review,your'deed"for any restrictions w ch May'app{y..
in consideration of-the'
ofthis requested permit i do hereby a're'e-thzit 1 will,.:in,all respects,perform the work
in accordance.witl ;the approved plans,'the Florida-6uilding Codes and'`St. Lucie County'Arne. ndments:
Zhe folfou ing Fiuil,ing;perm�ta.pplicatiQns are.exempt from undergoing a full concurrency review:room addivons;
accessary>structuresj swimming:po'ols;fences,:wells,signsf.screen rooms-and accessory uses:to.:ariother non-residential use:
WARNING TO;OWNER•Your failure to Record a`NotiOe of Commencement may result,in paying twice for
Improvements to your property:A m;m Notice of Coericem u ent must be recorded in.the;public records of,St.
Lucie County.and posted on,thejobsite before the first`i,nspe.ctiori.,Ifyou intend;to.obtain.financingf.consult
with lender or an attome : before commencin .Wrork.o'r'recordin our Notice of-Corrimencernent.
1
�gnatre of Ow Lessee/Corttrav or as Agent for owner'- Signature of Contractor(Lcense Holder
STATto F.'FLOAID , l STATE OF FLORIDA
COUNTY OF r . l_.t �c�_.`t- I COUNTY OF
i {
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and"subscr►bed before me of
Physical Presence,or. Online Notarization 1 Physics(Presence or:. Online Notarization
this 1�day,of ,t, 2020y this. day:of. 2020 by
j.Name of_pets ri making siaterrrent ? Name of person making statement. {
Personally I(hown v,`__'�'OR.Produced Iden Personally Known ,OR Produced Identification
Type'of Identificatidn .' Type•.of identification
Produced' Produced I
F.
(Signature, Notary Public=Stat`Af Flarlda) (Signature of.Notary Public-State of Florida
Commission No; (Seal ' Commission Na. (Seai) j
REVIEWS i FRONT ZGNING. ( SCtPERVISOR PLANS { VEGETATTQN SEATl1RTLE MANGROVE
yy I
COUNTER REVIEW REVIEW REVIEW I. REVIEW. REVIEW REVIEW
DATE
RECEIVED
ritb .,t�lY Y 8i't99'. mn_b xdc/f/ 1,,r\d].ybCd
CQMPLETED
� ev.