HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR-APPLICATION TO-BE ACCEPTED
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Date: i� � . Permit.Numb r:
`1
AUG 5 2020
Building Permit Applicata n0-1 i _
Planning'and'DevelopmentS'ervices ' '` `}
Building and Code Regulation Division Commercial Resid@Iitle�
2300 Virginia Avenue,fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: )-1 o LV ,.S.
AN
Address: `7 o of �' � 11= . . -JyC✓(
Property Tax ID Lot Na_ --
Site Plan Name: Block No.
Project Name: Id,,O-?7 'K
V\
New electrical Meter Second Electrical Meter
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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, 1 6 -7- — Utilities: —Sewer —Septi c Building Height:
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Nam ' 2
Name-.-
Company:
ame:Company:
Address:
Zig Code: Fax: City: State:
Phone No.�7 3 :2 9 0 7 Zip Code: Fax:
E-Mail: Phone No
Fill in fee simple Title 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: _.__.NotyAppl c: le
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 prldt.to the issuance_ofa.permit.
St.Lucie County makes no representation that is granting a'permit will authorize the perms holderto"buiid 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,l 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 m-paying,twice for
improvements to your property: A Notice of Commencement mush be recorde --Jn-the public.records,of St..
Lucie County and posted on the jobs to before the first inspection. lfy6wintend10 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 - STATE OF FLORIDA
COUNTY OF COUNTY OF.
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
cX Physical Prese ce or Oniine Notarization Physical Presence or Online Notarization
this ay of 20,=�)Vby this day of ,20_ by
Cua lrr(, e
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally-Known OR Produced Identification
Type of Identificati n Type of Identification
Produced ) Produced
01 A &1l� &L
(Signature of Na ry Public-State of Florida). (Signature of Notary Public-State of Florida.)
Commission No. AUDREY(l3MP10HREY Commission No. (Seal)
*: MY coMMjSSI0N#GG 300817
iES:March 6,2023
'`•Eb F;tiQ' Med Thru Notary Pu !io Undenm ers €
REVIEWS RVISOR PLANS' VEGETATION SEA TURTLE MANGROVE
'COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.