HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: '?b -:7 17,C) Permit Number:
LM L
Building Permit application
Planning and Development Services
Building and Code Regulation Division Commercial Residential /
2300 Virginia Avenue, Fort Pierce FL 34987
Phone: (772) 462-1553 Fax. (772) 462-1578
Address:
Property Tax ID #:. 3 �i0 Ll - 2() 0 OQ % � 200 - Lot No. �-
Site Plan Dame: Block No.
Project Name:
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New Electrical Meter Second Electrical Meter
1.
gONSTRUMON 1[VfORNt T9€?N:
Additional work to be performed under this permit -check all that apply:
Mechanical ____ Gas Tank —Gas Piping _ Shutters
Electric — Plumbing — Sprinklers _ Generator
Total Sq. Ft of Construction:
Cast of Construction: $ 577_G,�J
Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNLRjLESSEE,; - _
CONTRACTtiR
Name
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Name (e �0� 16 Iq C
(,i4
Address:
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Company:
City: . Ya State: _
Zip Code: 2552 Fax:
Phone No. 01 4 —&1 S -
Address: 353 NLN J c_" A'tet°
City: '0_� L-
Zip Code: '' Fax:
Phone No
State: / J
E -Mail: li0"Y)l 0 i!�,
Fill in fee simple 4e Ha er D next page ( if different
from the Owner listed above)
E -Mail Z 1l1 p�jc
t/� G'lJ. e,
State or County License ��
7
It value of construction is ZWO or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,506 or more, a RECORDED Notice of Commencement is required_
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DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
EJ
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 ofCommencement 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 our Notice of Co neem
Signature of Owne see/Contractor as Agent for Owner
Signature of Contractof/LI nse Holder
STATE OF FLORIDA
STATE OF FLORIDA-
COUNTY OF ,3zl L �_; L k f'
COUNTY OF tD
Sworn to (or affirmed) and subscribed before me of
Sworn t (or affirmed) and subscribed before me of
l✓Physical Preserve or, Online Notarization
physical Presence op Online Notarization
this � day of 2020 by
this Z�Lday of , 2020 by
Name of person making statement.
Name of person making statement.
Personally Known _Ll� OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
o'seph N. Brescia
I ' t soseph t3.8resc a
(signature of Notary P� jq)5M%FOB
Y
ature of NfJtary Pu fW� FLORIDA
,STATE OF FLORIDA
?,STA F
Commission No. > G,rWQA10NO2
Commission No. ` 1f1D402
"/VCE tie'+' Expires 5!212021
s4Nq iso Expires
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