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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: c Oh �- - D 3 V 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 PERMITAPPLICATION FOR:q PROPOSEDIMPROVEMENT LOC1ATIQN, Address: ir 1�a, S . -z, rg i -.A -s+. Property Tax ID #: O') L{ '69 (p a a. r)© �i I non Lot No. Site Plan Name: bola- Block No. a Project Name: 5r c &k rry %Z 2- 0 , f✓ -0 Gur-i r c.-4 c­ . t-D J 4 1-f C—Ar� L • New Electrical Meter 7�Second Electrical Metey� 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: �ri0-0 Cost of Construction: $ a , UI 14;'- • '00 Sq. Ft. of First Floor: Utilities: _Sewer _Septic Building Height: OWNEf L+ESSEE 4F aL s v"!N Fx]"v Sf` t 1'gvkp--•b: �� CONTRACTOR ' % ,Yvs: ] ..-r9 4 Name",-Ycl jyJ r Name: A ess: 5 41B . Company: Crty: e < State: • Zip Code:., a Fax: Phone No. o?-),Q I Address: ""' S: N 1. ., fiify ^= ='• •<'"t' - State:_ -Zip Code . r: ;' Fax: Phone No E-Mail: Vn4,1 .QnN Fill in fee simple Title Holder on next p (if different from the Owner listed above) E-Mail 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. SR.'REMENTALCONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable Name: BONDING COMPANY: _Not Applicable 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 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 attornev before commenciniz work or recordine vour Notice of Commencement. - Sign tdlre of Owner/ Lessee/Contractor a nt for Owner Signature of Contractor/LicenseHolder STAT.6'01` FLORIDA STATE OF FLORIDA COUNTYOF COUNTY OF Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of Physical Presence ora Online Notarization Physical Presence or Online Notarization this a"\,day-off 5/�\T 2020 by this_ day of 2020 by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of I ntification Type of Identification Produced ���.� Produced (Signature of Nota Public- State of Florida) (Signature of Notary Public- State of Florida ) Commission No. �*Crrd�+a a w.„ a r+ ;!7g!N. OEANNAMMEG N. Cc ission No. Seal (Sea[) W? MY COMMISSION q GG 02 Z023 �� Bon dTWNaisgPublleu REVIEWS FRONT :nnitere S VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED cev. 3/ D/ w