HomeMy WebLinkAboutBuilding Permit Application s Ub m 1 s c
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED - - - - ---- -"-
Date: Permit
x�, Y
AUG 0 2020iA
'
-- -- Building Permit ApplicationSL
Planning and Development5ervice5 �- ----- - - �_
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:
'� P`QE�JP �► l �EEtfI�QTt .t ., � , , � � � �k .. 1 �4� �.
Address:
Property Tax ID#: `Y�� )I /�` ��I/J q _ Lot No.
Site Plan Name: Block No.
Project Name:
i s< 'w t h Ye {,E..,,''•`", $-.
.y
65li'
d
�J 400
Et�e 77-
New electrical Meter Second Electrical Meter „
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 _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ A 04)C.", °d Utilities: —Sewer —Septic Building Height:
4 �, � � GOiVT CTUR•
3�
Name 4nl �*2_ Name:
Address: ,
�� r � ;F f VIS-74- 6�4)— Company:
City: r � t1 State: .l Address:
Zip Code: 11/5 E-3 Fax: City: State:
Phone No. _2- S - S Zip Code: Fax:
E-Mail: ndxy '/_ PC 7,/ Phone No
Fill in fee simple fitle Holder on next page (if different E-Mail
from the Owner listed above) State or County License
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 MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable . BONDING COMPANY: iNot Applicable
Name: Name:
Address:, Address:
City; City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIWIT: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,1 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-Noticeof 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 attorneybefore commencingwork or recording our Notice of Commencement.
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Signature of Owner/Lessee/Con actor as Age for Owner Signature of Contractor/License Holder .
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �l t-�. COUNTY OF
Sworn to{or affirmed}and subscribed before me of Sworn to(or affirmed)and subscribed before me of
�K Physical Presence or Online Notarization - Physical Presence or Online Notarization
this day of 20-7 0 by this day of 20� by
_
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification "� Personally Known OR Produced Identification
Type of Identificat1 �) �� ) Type of Identification
Produced t / �� Produced
{Signature of NotUr Public-State of Flori , , ,„;
d {Signature of Notary Public-State of Florida)
-a,
Commission No. :of Y° AUDREY B,HUMPHF.'EY
COMA915"91 0�% u6817 Commission No. (Seal)
EXPIRES:Msrch 6,':,'23
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REVIEWS FRONT ZONING SUPERVISOR PLANS' VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.