HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 71 2 812-a Permit Number:
f if
9)LY. Lucas
AL) �"_u a Building Permit Application
Planning and Development Services /
Building and Code Regulation Division Commercial Residential &1
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
I PROPOSED IMPROVEMENT LOCATION: _ I
Address: Z // Z Alg tfIrs 13/v ✓
Property Tax ID #: y5O2 -Sd/ -O//S -Oea- p Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter �h, O Second Electrical Meter
Block No.
I CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit -check all that apply:
Mechanical
Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $S/ 9� D
_ Gas Piping
_ Sprinklers
— Shutters _ Windows/Doors _ Pond
_ Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic
I OWNER/LESSEE: I CONTRACTOR:
Name Ica
Address:2l/l
City: 12or e S,v z f / State:
Zip Code: Fax:
Phone No. 9'3 7 - 740
E-Mail:
Fill in fee simple Title Holder on next page ( If different
from the Owner listed above)
Building Height:
Name:A-Aw c,�
Company:
Address:_/ 7iC /I/_ 131,,
City: Aari5 Stater
Zip Code: 3 j95Z Fax:
Phone No77L-Lo)-4j
E-Mail,T/i
State or County License�Gwy��
If value of construction Is 25W 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: of Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: _L-AhSt 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 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 attornev before commencing work or recordine vour Notice of Commencement.
or
gnature f Owner/ Lessee/ ntract r as Agent for Owner
nature f Contractor/License Holder
STATE OF FLORIDA II'
STATE OF FLORIDA
,
COUNTY OF �I� l
COUNTY OF May`hr-�
S)m9T to (or affirmed) and subscribed before me of
Online Notarization
Sworn to (or affirmed) and subscribed before me of
✓Physical Presence Online Notarization
agI Pres nce or
sof 2020 by
or
this day of fh l9 uS� 2020 by
&�l U(C.IJ(rW V I Ul a 5 C _0(0
/ht- ID n M. u M GtSCi P f 0
Name of person making statement.
Name of per on making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification Y
Type of Ide cati n
Type of Identification,
OVA �✓ i ��Se
Produced�yp_
Produced
(Signatur of Notary Public- State of Florid )
(Signature of Notary P blic- State of )
Commission No. (Se ,,f
Commission No. �d
My 0 mmisslon Exl*es oBlOsM=
Cwn"on Nm o0 225309
M OOmNgion li0. OG 9699n
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/n/2u
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -% Z $_ '_:7 Permit Number:
Luau
0
e n Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential T/
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: _2_ _I Z_ 1 d. fAicc d1llr.!-
Property Tax ID #: sd2 -T471 -4i/ S -ppd -_o . _ Lot No,
Site Plan Name:
Block No.
Project Name: 5 .'."
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Ile Second Electrical Meter_,..L�_
CONSTRUCTION INFORMATION:
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 Construction:
Cost of Construction: $4 e'y G
Sq. Ft. of First Floor:
Utilities: — Sewer — Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Nameka 7 iet.,
NameA-A,9iy /77e�� �0
Address: 21/e " /j G
Z�� �
Company: Z11l.;�s�
City: 12dr State: _g!�<
Address: 7S' -
Zip Code: Fax:
city: '0'X e T.Eryy t �/��Q State:�
Phone No. 7.3 J - 7wl4V - �2 TJ
�
Zip Code:. x %9sJZ Fax:
E-Mail:
Phone No7 74`0-07 ` G�
Fill in fee simple Title Holder on next page ( if different
E-Mailg,14-9221L�
from the Owner listed above)
State or County License
IT 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.
ENTAL CONSTRUCTIONLIEN LAIN INFORMATION:
ENGINEER: Not Applicable
F
MORTGAGE COMPANY: of Applicable
Name:
ess:
Address:
City: State:
Zip: phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _L,-Not Applicable
BONDING COMPANY: Nt:5t Applicable
Name:
_L
Name:
Address:
Address:
City:
City:
Zip' Phone:
Zip: Phone:
nwwR/ rniurDArTna ACEM111T.._._.__
— -- ---•- •�� •��� r.� l ow— i . ANPnl-cmun is hereby mace to ontain 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 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 our Notice of Commencement.
gnature f Owner/ Lessee/ ntract r as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
SSw9M to (or affirmed) and subscribed before me of Sworn to for affirmed) and subscribed before me of
Physi al Pr nce or Online Notarization Physical Presence or Online Notarization
isy^of 2020 by this day of 2020 by
Name of person ma ing statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Ide cati n Type of Identification
Produce VQ( Produced
(Signatur of Notary Public- State of Florid ) (Signature of Notary Public- State of Florida )
Etmbem NM*
Commission No. (Se�pt"lic
�tent�ds Commission Na. (Seal)
Wy commission Expires OBm m022
Commiseion No. GG 225309
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.