HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: PermitNumber:2oo
Building Permit Appli�ation JUN 2 G 2020
Planning and Development Services Permitting Department
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie C 01 n t'yi, F.L.
(772) 462-1553 Fax: (772) 462-1578 Commercial esidential-4/
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 2053 N6T%Z2S 13L✓O. S2r%�2� ae4G/ •.�'
Property Tax ID#: `YSOZ �S�i' '-00-5 6`^ 000- Lot No.
Site Plan Name: Black No.
Project Name: t/ I 144r, -roJR' goet'/
DETAILED DESCRIPTION OF WORK:
0
CONSTRUCTION']NFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ � Chi eq . O cD
_ Generator _ Roof
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name P.47?z-XCz4- 6 /6zeGc7
Name: M�U�fifrL �xUnz�
Address: 2054 Ak77-b4?-r eL✓,
Company::21 . et.a- Co 4sc /-,n!fr•e JAG
City: Yam% Qn.',or- State:
Zip Code:-91/9Y% Fax:
Phone No.
Address: Address: /ZOo GyT ✓r�/ZD•
City: '57z't rL7' State: /=L
Zip Code: 34?9V Fax:
Phone No(.77Z) f' ZO -3& 2;5
E-Mail: ¢) 13,g 111- o .Cc� r
Fill in fee simple iiitle Holder on next page ( if different
from the Owner listed above)
E-Mail7yze rsuo., Cr>n ur�� pox �[iAl%aa 111y
State or County License
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or anrJ 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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTIW .—IF-Y U INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. -
'Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contra or/License Holder
STATE OF FLORIDA
STATE OF FLORIDQ, _ ��
1 IR
COUNTYOF
COUNTY OF
The forgoing instrument s acknowledged before me
The for oing instrument was acknowledged before me
r C--
this �. day of ► I 20 ) by
this day of ��l'I , 20 zo by
y'cxa Ayeuo
nuA C ° 6c
I
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced cty&
Produced
(Signature of Nothry Public- State
F Si1�8�) LUCIA CRISTOFOA
31(Sign
ture of Notar; Public- Sta a Notary Public - State of Flo
Commission No.C-�jaL
x°k Notary Public • State of
{'�' Commission p GG 21
I I)
. Of
�Bondedythroom Explres May
Florida
7,c
e'3' &pj commission a GG 21926
,,or '��y yqmm, Explres ,Nay 17,
fission No. ooclQo� ldBdAf
Bo a ough National Notary
rough Naticnal Not
r Assn.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.Z/7/19