HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICA LEI FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: k y l 20 Permit Nu
V Building Permit Appiilca
Alonninq and Deveiopmenf Services
Building and Code Regulctian Division Commercial
2300 Virgini❑ Avenue, Fort Pierce Ft 349$2
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: r
PROPOSED IMPROVEMENT LOCATION:
Address: �)Io In S1 Lucie
Property Tax ID #: Z> t*2`4 ~ -70'L , oogci
Site Plan Name: 1
Project Name: 1
DETAILED DESCRIPTION OF WORK:
t S
h s _P
New Electrical Meter Second Electrical Meter
[CONSTRUCTION INFORMATION: -
Additional work to be performed under this permit -check all that apply.
tuber:
tion
Residential
Lot No.
Block No.. �Y
_Mechanical _ Gas Tank _ Gas Piping Shutters —Windows/Doors Pond
_Electric —Plumbing Sprinklers _Generator Roof Pitch
Total 5q. Ft of Constructian; )L404 Sq. Ft. of First Floor: IL404
Cost of Construction: Utilitles: XSewer _ Septic Building Height.
OWNER{LESSEE: ,
Name `t' M(AA
Addr s: S 7
City: t cState.
Zip Coder Fax:_ OA
Phone No.
E-Mail: r�
Fill in fee simple Title Holder on next page (If different
from the Owner listed above)
CONTRACTOR, - - — -�
Name:_Luis W11` e-S
Company: +AeIrrCLA CW 6rt)
Addrersss:� S �JJ
city: i' i . � ��i e(r_,L 5tate:
Zip Code: L�q4] Fax: 01 A
Phone NQ -112 LW -' I CO- -
E•Mail, Iflf 0_6'_ + z. . cwo
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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SUPPLEMENTAL CoNSTRUCTI0N LIEN LAIN INFORMATION:
DESIGNER/ENGINEER., Not Applicable
MORTGAgE COMPANY: Ncit Applicable
Name; KILN
_
Name: UVN
Address:
Address:
City: Stater
City: State:
Zip: Phone
Zlp: Phone:
FEE SIINPLE TITLE HOLDER: , Not Applicable
"I"DING OfV1PAf�lY: _Not Applicable
Name: r _
Name:
Address:
Address;
City:
City:
2Ip:� Phone:_
Zip: Phone-
OWN ER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtaln a permit to do the work and Installation as indicated.
i cer:rfy that no work or Installation has commenced prior to the issuance of a permit.
5'- Lucie County m;'kPs no representation that is granting a permit will authorize the permit holder to build the subject structure
which is irr 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 wlll, In all respects, perform the work
in accordance with Vie approved plans, the Florida Building Codes and St. Lucie County Amendments.
The follow) ng building permit applizatians are exempt from undergoing a full toncurrency review: room additions.
ac.Eessary 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
imprauements to your property, A Notice of Commencement must be recorded in the public records of 5t.
Lucie County and posted on the jobsite before the first inspection. If you Intend to obtain financing, consult
with lender or ar7 attorne)tbefore commencing work or recording our Notice of Commencement.
Signature of owner/ Lesse Contractor a Agent for Owner
STATE OF FLORIDA
COUNTY OF 0�!,lilI er
Sivyn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 0 2020 by
4 �-
Name of person making statement.
Personally V.nown OR Produced Identification
Type of Identification
Produced
Commission No.
REVIEWS
RECEIVED
DATE
COMPLETI
Public- 5ta
5lgnatufe of Contractor/License Holder
STATE OF FLORIDA COUNTY OF &�I I fl-
5 to (or affirmed) and subscribed before me of
P ysical Prese ce or Oniine Notarization
this _ day of 2020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identifi[ation
Produced
JENNIFER L B AfJV I
Leto 41 Fiarider 11101 r�x[__f urti
Corn rftteeLpn A GG fi
Fit jr �{+I'It rrV1961fJn .t1ir��
a 4 Nd%W Public- State
n No,
if iylF t N I FR NOT
t IS r •utnitm�iti5 t u#S
FRONT - ZONING
CONTER I REVIEW I
S REVIEW OR I
REVIEW PLANS I �REVIEWON I
S REV EWLE � REVIEWVf
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