HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: zci2 Permit Number:
�Ir
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
Residential I/
PERMIT APPLICATION FOR: I , �_a rcx_-�(-
PROPOSED IMPROVEMENT LOCATION: QQ�cf. l�i1C � i-I- r r 1 3VfFJ
Address: A
Property Tax ID #: 2-419 , L3-L� - C)DO3- oco• 0 Lot No.
Site Plan Name: Block No.
Project Name: (l nc,
DETAILED DESCRIPTION OF WORK: i't,_czr d-ourN --U PiyWt 0cA
'xrti—'-�'W'n-t- -, 0.0m Eu r d.,.. w,r- , -L
cr dniy) s needed 11 .C-E 2&Xr-lo oode, cirwe6jce 40 GDde
17)"1 ano 0(_,vYne,4_rc., _sk,, vd 1)oA,,_ -4n r,,i,- ,,14." i
New Electrical Meter Second Electrical Meter
I 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 4ZRoof I Z Pitch
Total Sq. Ft of Construction: 2360 Stf
Cost of Construction: $ B oDo t 150
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name I1�' '5 0 (� r i 0
Name:
Address: 2gIR' iMC 06,d RA
Company: Floriao_ COn-fd.,(': catylc, w ri
City: I CV' _Iea State: (_I
Addre s: I - `Jr'1 - IV ow �.t�
Zip Code: 34q?. ( Fax:
City: llf y ) uc'lc, Stra�te:
Phone No. - 00 • ` 03`3
Zip Code: � Z Fax: /V �•i 7
"T"12_
E-Mail: ` o Inof WO @ 0SYYk.0ASaJ
_
Phone No Lam"1 LD 2b b
Fill in fee simple Title Holder on next page (if di ere't
E-Mail i W11 Cf, CY-5 J I C. - m
from the Owner listed above)
State or County License CCC ' 133 1`�-
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: — Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not 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 Amendmenp.
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.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature Contractor/Lice Hold r
STATE OF FLORIDA
COUNTY OF Lu c_L�
STATE OF FLORIDA
COUNTY OF FL �
Sworn to (or affirmed) and subscyibed before me of
Physical Prese ce or G Online Notarization
this day of �t. fir- 2020 by
Sworn to (or affirmed) and subscribed before me of
hysical Piesence or Online Notarization
this 31day of J- —� 2020 by
0, ��'� a L" ll l,C J 0—�-V L �i
�iV y r t�yV Yam- ( C %t X
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produce
Personally Known OR Produced Identification
Typ�of-Identification
Produced f
Notary Public State OfFon(Sign
(Signature of Notary Pub c- SZEK
Pamela Jones
Commission No.al on,
�� �024 68
ure of Notary Public to ,J_ori
'',, Public State of Fionda
Z 'I' Pamela Jones
CAm sion No. l r" Ic 3 _ g Expires DWI on GG 985470
ww Expires 1512024
0-4��]
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.