HomeMy WebLinkAbout120 liberty way permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
�4 LLLu m
5i
Permit Number:
Building Permit Application
Residential
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: kcpoo� �6 54
PROPOSED IMPROVEMENT LOCATION: J
Address: aN �t" btr4' it I JAr� 3` ... 15) —
Property Tax ID #: 13lo`L i 4 m l a.- Opo Lot No.
Site Plan Name: Block No. l
Project Name:
DETAILED DESCRIPTION OF WORK:
o k- 5.9 rl+ 1000f &06
'r,ri b0 k- SrAdoki„ r,aef- Iry fL - [46 4 Q,- 126 1 AD IY61455 v5A On+ kou frla*M-t
Ifl; A C_Orr l&ekk'nq 5-0 IrL- 16 Sy - gaq CA AC3 COL
New Electrical Meter l°Z_Lconglectrical Meter
CONSTRUCTION INFORMATION: I
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 Y Roof � )2- Pitch
Total Sq. Ft of Construction:
Cost of Construction: $
Sq. Ft.. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
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Name Ila e UGr�GS
Address: IAO i +Y uiei')
Name: r
Company: li '�J M ,
City: '[.f R. State: EL
Zip Code: 3`{ _ Fax:
Phone No'? 113-11Zip
E -Mail: -r? . -Oyv)
Address:3g3 15", 1 !;0
City: 4%rO kntll _ StateJrL i
Code: V(111111- _ Fax:
Phone No'71 - -)
Fill in fee simple Title Holder on ne page ( if different
from the Owner listed above)
E -Mail i' 1 7 7.)L
State or County License % g a
IT value Ui Construction is ZSUU 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 MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
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 thepermit 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 t your property. A Notice of Commencement must recor in the public records of St.
Lucie County posted on the jobsite before the first inspecti 4�rt)le
nd to obtain financing, consult
with len r a tt fore commencin work or recor of Commencement.
Sigffature of Owner/
as Agent for Owner � Signafure of Con ractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ' , ::2C: f COUNTY OF Y, kiC -\ &Ut-_K —
Swor to for 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 Ll day of 2020 by this � day of c>C 2020 by
T _/
C WlI����� l�
Name of person making statement. Name of person making statement.
Per Wali Known OR Produced Identification Personally Known OR Produced Identification
Type of I entifi�ation, Tvpi of Identification
(Sigazure o
C missio
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
LIlr ym
NO" Public
Laura Yewa
Notary Public
Notary Public- State o�a J
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FRONT
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SUPERVISOR
PLANS
VEGETATION
SEA TURTLE MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
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