HomeMy WebLinkAboutBuilding permit ApplicationAll APPLICABLE INFaMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /
CC3'L1 N T Y
Planning ond'DevelopmentServices
Building and We Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address: ? 02r
Commercial
Permit
t� J
JUN 16 2020
itting Department
Luck- JuntylWill—FL
Property Tax ID`#:, yJ�U���O-600-0i,38-00a-4- Lot No. 13
l/ Site Plan Name: Le�X'4. (PJ P2&t f(J / Block No.
Project Name: Y—XAA� >-J�
DETAILED:.DESCRIPTIOWOF WORK:
aiLnD„t/tff/too/. dl e�ora•
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windowp/Doors _Pond
Electric _ Plumbing _Sprinklers _ Generator —Roof Pitch.
Total-Sq. Ft of Construction: 6VO Sq. Ft. of First•Floor 4 & /,I�
Cost of Construction:000.E Utilities: _Sewer _Septic Building Height:
OWNEftESSEE:
CONTRACTORz
Name
Name:_.
Company:�SJ
Address: 8yD8 COWWA ,7.a>? AW—
City: fimt GPhClt% -State. H
Zip Code: 3s/9Srf- Fax:
Phone No. 7%Z 50 7 - 371.l�
Address: IaVd 5dO a
City: a State. re
Zip Code: :351?P 7 Fax:
Phone No 7707 46-; -J 3519e
E-Mail:
Fill in fee simple Title Holder an next page (if different
from the Owner listed above)
E-Mail���/
State or County License (_B a Li 6 'oi / od -
If value of construction is 2500 or more, a.RECDRDED Notice of Commencement is regmrea.
If value of HAVC is $7,500 or more, a MCORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
Not
P. c
City:
Zip:.
FEE SIMPLE TITLE HOLDER: ( Not Applicable
Address:
City:
Zip: Phone
MORTGAGE COMPANY: Y Not Applicable
Address•
City: State:
Zip: Phone:
BONDING COMPANY:
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 coriflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Assoaation,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 attomev before commencing work or recording vour Notice of Commencement.
\'fl[�/A�T
Signa'fure of w0 ner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA STATE OF FLORI/
COUNTYOF S7 i/�e+% COUNTY OF
Sworn to (or affirmed) and subscribed before me of
is Physical Presence or Online Notarization
this day of �� L2 n — 20_D by
Personally Known /l OR Produced Identification
Type of Identification
Produced �^
4' b
(Signature of Notary Public -State of R
Florida
Comnil ssIon No G 020
Sworn to (or affirmed) and subscribed before me of
Physical Prese. rce or —Online Notarization
this ay of,2QfZ by
�L-,A.i.1 LA.tJD�QS
Name of person making statement
Known 1/ OR Produced Identification
Type
.-'= State of
if Notary
No.
REVIEWS I FRONT I SUPERVISOR I PLANS
ON
COUNTER REVIEW REVIEW_[ZONING
DATE
10
SHERRI KELLEY
2020
SEATURTLE I MANGROVE
REVIEW REVIEW