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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLE i ED FOR APPLICATION TO BE ACCEPTED'. Date: PI/S fie) Permit Number: JUL 18 2020 _0 0 p ©,ppW Building Permit Application ST. Lucie County, Permitting Planning and DevelopmentServices 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: PRO,R ED IMPROVEMENT LOCATION Address: % Property Tax I D d: Site Plan Name: _ Project. Name: , ,,,a Arc 6, f ?, P,« f- C)I-&K7. 0101- 000 A'0'r4 coot Lot No. Block No. New Electrical Meter Second Electrical Meter CONSTRUCTION INI0'RIVIAT10,' j 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 CoCion: u tion: Sq. Ft. of First Floor: Cost of Construe$ 0040 Utilities: —Sewer —Septic Building Height: OWNER/LESSEE:: f"' , CONTRACTOR: Name 4 z e- Name: Address: -750S 64U,aa Ave Company: City: ror+ ere- State: FL Zip Code: 51T5/ Fax: Phone No. 93 7 (,ao itt5 Address: City: State:_ Zip Code: Fax: Phone No E-Mail: ,m4-ff aJ, 1-k�- 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. SUPPLEMENTAL CONSTRUCTION,LIEN`LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY:' _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable 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.conTlict 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 attorne a commencing work or recording our Notice of Commencement. Sigriature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTYOF Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of. Physical Presence or Online Notarization Physical Presence or Online Notarization this V'''� S day of U 1\1 2020 by this —day of 12020 by 1 Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notar ublic A; y oridaoJ MNAMARI 023 i nature of NotaryPublic- State of Florida g ) M'(COMM193H)N>��B TA Commission No.Oa? �cdN,m°eom yKuo�^ mmission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.5/b/20 KI