HomeMy WebLinkAboutOconner gen permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
J Building Permit Application
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
PERMIT APPLICATION FOR: tl --7
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID #: _,a ,2o(% "' rU 7 "'(�,()I),
Site Plan Name:
Project Name:
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
r U
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ J3; 00
Lot No.-lep
Block No.
_ Shutters _ Windows/Doors _ Pond
XGenerator
Sq. Ft. of First Floor:
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name k1of if Y Name:
Address: /LDS Company: 61
City: '6-L State: FY Address: 6 G
Zip Code: Fax: City: t- QC
Phone N a 9159Zip Code: 0
E-Mail: 1" Ire° %r l�G Phone o J-4
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.
Fax:
ve-
_ State:
SUPPLEMENTAL CONSTRUCTION LIEN LAW -INFORMATION:
DESIGNER/ENGINEER: _ Not Appli 1161le
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY:
Name:
Address:
Citv:
Zip: Phone:,
FEE SIMPLE TITLE HOLD , _ Not Applicable BONDING COM
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip:
Phone:
Applicable
Not Applicable
OWNER' CONTRACTOR AFFIDVIT: Application is hereby made to obt9r(n a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance# 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
with lender or an attorney before commencing work or recording your Notice cif Commencement.
Sig re of Ow r/ Lessee/Contractor as Agent for Owner
Sig
E OF FLORIPA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
P PPh sical Prese ce Online Notarization
thisdaPy of o 2020 by
]to ft n t�r
Name o person making statement.
Of.
Holder
STATE OF FLORI
COUNTY OF f'1( Q ��
Swo n to (or affirmed) and subscribed before me of
Physical Presenc or Online Notarization
this 14 day of 2020 by
s �r
Name of person aking statement.
inall*Known OR Produced Identification Persc
of Id tificaticini Type
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6/20
0
(Signature of NotaryPubl
o Notary Public State of Florida
Charmin D Walker rrS
My Commission = G 225821
�o Expires 06/0612022
FRONT ZONING ! SUPERVISOR PLANS
COUNTER REVIEW REVIEW REVIEW
OR Produced Identification _
rid
'l J�p Notary Public State f Florida
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�I D Walke Seal)
N z My Commission GG 225821
.4 Expires 0610612C22
/EGETATION SEATURTLE MANGROVE
REVIEW REVIEW I REVIEW