HomeMy WebLinkAboutBuilding permit applAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
El UP, LF
V `° �" 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:
Address: 2 /6 5r'+�-`II'"l I YE;0_ Ape-. � . 191�II3yi 1C� y
Property Tax ID #: 31 ), "l ��000 t 00065P
Site Plan Name:
Project Name:
New Electrical Meter Second Electrical Meter
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:
cv�
Cost of Construction: $ 2 000,
Name I_0A'VIV PE TUASOAl
Sq. Ft. of First Floor:
C�
Lot No.
Block No.
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
Address: S (v Lk /4-, s 1.,
City: i i L('�� State: I-"`
Zip Code: 3yqy`7 Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:- ULI- AIAl J',(�/L
Company:4-,V2mng %~Y
Address: 9' 37 At )L-141 67,S ff'W y
City: State:'
Zip Code: �� Fax: -?7a'
Phone No i L7 _ L/J 0)
E-Mail f\ V_'�q �P
State or County License C --C. 13 ,3 i-,5-7i1 D
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.
DESIGNER/ENGINEER: _ Not Applicable
Name:_
Address:
City:
Zip:
Phone
State
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
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 recording vour Notice of Commencement.
Signature o Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA ( �
STATE OF FLORIDAS / '
COUNTY OF of 7 Gt4LC�
COUNTY OF T— _U �
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
✓P�4sical Presence or Online Notarization
y
✓Ph sicaI Pres nce or Online Notarization
�
this day of 2020 by
this day of 2020 by
N ;of person ma/2i tstatement.
�/✓
Namg_ person majs�ngUIVAI statement.
Personally Known OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
BETTY PRIDE
BETTY PRIDE
(Sign ture o Notary P b1i, �rJ6�y�?� 20-22
�;• ,
(Signature o Notar6yPubli t , I h 7,2072
Bordad Thru Troy Fain MumCa OOC 38b7818
7 • w( ' � 1 11104 T 0*y Fain Murano 80 ,48S.
Commission No.
Commission No.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20