HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO* MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a.d a -a Permit Number:
•
Building. Permit Application S.
Planning ond'DevelopmentServices I
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: '
PROPOSED -IMPROVEMENT_ LOCATION:
Address: 60// 10 /tom F.6 4)/,e G2� . G/_ .?,41912
AUG 2 ®. 2020
• o Property Tax 0M ,34-laa. 4a - Ox/g/- O00 M to Lot No. 629
Site Plan Name: aitol4%, R oko duel " _-apq Block No.
Project Name: (Z
DETAILED-, • • • '
r
New Electrical Meter
Second
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all 'that apply:
_Mechanical _ Gas Tank Gas Piping _ Shutters
_.Electric _ Plumbing —Sprinklers _ Generator
_ Windows/.Doors „ Pond
Roof Pitch.
Total.Sq. Ft of Construction: - a� jM Sq. Ft. of First'Floor:
Cost of Construction: $ �. 90�• ov Utilities: _Sewer- _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR,
Name ' o
Name:
Address: / .)
Company:.
City: Fat Sd.Ci4x.6 •State, jQ
Address:l3�J��C�.6�.�
Zip Code: JVMZ Fax:
City: +,)OttStater
Phone No. o?D/ 'S/ 3- 4/ 38 '
Zip Code: T ed Fax:
E-Mail:_AJQ6�ACdLQ?ME. LOPT
Phone No •f7� yo11 '6'5-,9'%
Fill in fee simple Title Holder on next page { if different
E-Mail• C4sr"**1
from the Owner listed above)
State or County License-C IoZr 3S31
It value o! construction is 2500 or more, a.RECORDED Notice of'Commencemdnt is required.
If value of HAVC is $7,500 or more, a MCORDEb Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
LAC..
Name-
Addre s: / /
/D/
Address•
City:
Stater
City: . State-
Zip: ,V^.Sa2 Phone 9s//
091-S "mo
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
/Not Applicable
BONDING COMPANY: YNot Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
vwivew LUnITRALTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installafion.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 Associationland 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 y� intend to obtain financing,=coiYsul ,
o with 'lender w-an attamev hpfnrn rnmmpnrinSAinrir nr rnhnv rriinn .0 f'+;-- —,F r.....................s
1
i �,, r ontractor as; nt for Owner
, %nS" a" t e Contra - Licens Hold
STATE OF FLORIDA
COUNTY OF wok, E
STATE OF FLORIDA ' r
COUNTY
OF
Swoq to (or affirmed) and subscribed before me of
kf Physical Prese '
Sworr to (or affirmed) and subscribed before me of
ce or Online Notarization
this � day of 5 20-U
✓ Ph sicaI Presence or Online Notarization
by
this {;'day of vS 20 2,o by
l��°�-try �• �1�� ��S
� . � �,,t.s
Name of person making statement.
Name of person making statement
Personally Known V�' OR Produced Identification
Personally Known OR Produced Identification
Type of ldentifi 'on
Type of Identification
Produced
Produced
mature of°, bli = '',,,,rr
NI"t'�i:C111MISSION # GG1400
0 mature of Notary is St tq
�� ..
Commission No. I M1 E, eaVS August 30, 2021
l�
IVI.. I JOSE M REYES
ommission No. 14 �(S¢��AMISSlON # GG1
EXPIRES August 30, 20
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
eye_