HomeMy WebLinkAboutBuilding permit appE
All APPLICABLE INf 0 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /3/ a0�� Permit Number:
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Building Permit Application
Planning and Development Services /
Building and Code Regulation Division Commercial Residential •V/
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: ` scr
44,1.,
PROPOSED IMPROVEMENT LOCATION:
Address: 3�� SC r9ra��' e AV✓ T
er
Property Tax ID#:3N/y—5302901c9-00'D'a Lot No. 30
Site Plan Name: Block No.
Project Name: .Scp( %� y-� G�{.T Scwc.-
DETAILED DESCRIPTION OF WORK:
PJC C L ln4 01.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical Szas Tank —Gas Piping _Shutters _ Windows/Doors
_Electric ✓_/Plumbing _Sprinklers _Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
o� —
Cost of Construction: $ >> s �. Utilities: / Sewer _ Septic
Building Height:
Pond
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name .9-N / e.rg1
Name: N rr
- 9 tr
l`�'
Address:
Company: l'+cc,u r'0' Sc CrV�GCf_ nC-
CltY: State: �Y
Zip Code: .�Ll ISM Fax:
Phone No. S(e�— y
Address: IA(9 9e v; EZ 'zQn
City:i g�� r
L ct� : !_
State
Zip Code: Ie/9�/ Fax: �7d-L(�Y-777,r
Phone No �2 7 ,;L - of f - L/cf / /
E-Mail: i✓la
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail_ 30rJ e r4cr r4 r�Sc
State or County License 4 r C- /Y-'L£t.53
�«..n"Eu uwme or a ommencemem is regwrea.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
rDESIGNER/ENGINEER: _ Not Applicable I MORTGAGE COMPANY: _ Not Applicable
Name:
Address: Address:
City: State: City:
Zip: Phone Zip:
FEE SIMPLE TITLE HOLDER: Not Applicable I BONDING COMPANY: _Not Applicable
City:
Zip: Phone:
Address:
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 attorney before commencinig work or recordine vour Notice of Commencement.
as
STATE OF FLORIDA
COUNTYOFli�r.'�
SW to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this —,/_ day ooff % by
y'�s 7z?,",P'J1e"95
Name of person making statement. -
Personally Known / OR Produced Identification
Type of Identification
AEISSA V BROTHERS
Commission No. '?:' k'i`: Notary Pu; J(j881oe of Florida
Commiwcr = GG 213104
Ay Comm. ?.?ire$ Apr 11, 2021
REVIEWS
COUNTER ( REVIEW I REVIEW
RECEIVED
COMPLETED
OF FLORID
rYOF
Swgm to (or affirmed) and subscribed before me of
Physical Presence or _ Online Notarization
this_?/ day of / 2020 by
fName of persCrrrnaking statement.
Personally Known OR Produced Identification
Type of Identifi tion
Prod
(Signature of Notary Public- State of Florida )
Commission No.
Notary Public - State of Florida
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