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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED. Q Date: `�' �Z.� Permit Number:a� l�` ' xU 12 2010 - - - Building Permit Application , prmit'ing Department ,. St. Lucie Cow,t„ - Planning and Development services" d! 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� Address: �� L9 coe- aL .r ry Property Tax ID#: 1 �© (' �D 1 2' 03q� - ©00' 0 Lot No. Site Plan Name: Block No. Project Name: DE LDS MMINI= L et. Ar. L::kk bK t� �l 'c New Electrical Meter Second Electrical Meter We 9 N;STRUCT ON INFO A ION: 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:$ -!6 U V 6 . Utilities: —Sewer —Septic Building Height: OWNS W__R E: CONT A TO Name �2-C �C�'(�..`�-� ., .., Name �r2,1C W., �,e�� _ s Company jar 1 -L...d Gty. State:�. Address. ;' 21 Zip'tode: �(4 -Z ;Fax:_- - City: Vt•to 'QE.�r.t,_ State: f?. Phone No. 112- 2 - SSG Ut Zip 7(e E-Mail: Phone No 7 72 71 OCR 7[6 Fill in fee simple Title Holder on next page(if different E-Mail aff AICS ^,4 Z Z &t/+n&J- G ohs from the Owner listed above) State or County License 644 JAI? b 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 CONS RU ITION LIEN LAW INF©RMATI©N. 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: 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 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 attorney before commencing work or recording our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA/ASTATE OF FLORIDA COUNTY OF COUNTY OF Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of Physical Pr sence or Online Notarization Ph sical Presen or Online Notarization this day of i 2020 by this—1�? ay of 2020 by as 1� Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known. OR Produced Identification Type of IdenY cation Type of Identific do Produced Produced �- (Signature of No (Signature of No - r ait KAREN S. NIELSEN �. (�IIELy PN `` PY P( i ,,�` �e �`' a%'�-State of Florida-Notary Pub is Commission No. ;20 ��;State of Flori �tary Public ;_° �: 20748A Commission No. - =c Commission g =* *= Commission # G 207484 - _ Nx fires My Commission Expires P; My Cornmi ssion P P June 12, 202� n REVIEWS ZONING. SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.