HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit NumbeST. LUCIE
r:___- �
o AUG 2, 6 2020
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial ResidenAia.l!3cL'00)0 'vs
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: i f 7 (�ePA C, e:- icisriAn, ('F ki r.,fc_h ,nSayi . lovic) FL
Property Tax ID#: 14 l76 - 1 00p-6 Lot No.
Site Plan Name: CAe-`y ,Uyli'yli mp Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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: 10`t Sq. Ft. of First Floor:
Cost of Construction: $ iz e)( ) Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name C A �— i' C� �Y�( 1 �11�j --e►'1C+"T;I
Address: e `.C ` 'h C �: SVA `-Vc-,rt-i's C) n
City: I State: Address:Sa.8`� P-6
Zip Code: 3'1 1 J H y Fax: City: State:
Phone No. `Zip'Code LY.,Ltq,5.
E-Mail: Phone No 7Z9 --5 Gel
Fill in fee simple Title Holder on next page(if different E-Mail,cicn
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.
SUPPLEMENTAL,CONSTRUCTION LIEN LAW INFORMATION:
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:roorn 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 attorn fore commencing work or recording our Notice of Commencement.
ature of Owner/Lessee/Contractor as Agent for Owner Sig a re o ontractor/License Holder
STATE OF Fii n1RIDA,
; ` 1p STATE OF FLCIIIIA
COUNTY OI FCUt,tq
+
SVprn to(or affirmed)and subscribed before me of SV9m to(or affirmed)and subscribed before me of
P ysical Pres nce or Online Notarization P ysical Pres ce or Online Notarization
his
tday of 2020 by this day of 2020 by
/ 1 S _
1
Name of p rson making statement. Name of person making statement.
Personally Known-OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Type of Identification
Produced Produced
,go,/1,1 pql)- 7T� P lo-
(Signature of Nota Public-S ate of FloridaJ ignature of Notary Nubli - !�.�� .
SARAH J, MARINE SARAH J. MAMINE
Commission No. ���`� B�� St JfEe71)Florida-Notary Publ I' mmission No. �2�� °��,Stat� l�H��-N®t�fy Public
►_ Commission # GG 27333 commis5ign #t 90 27 338
c-�ca�333F� y cava-�333g - AP: M qoml� �4P�rps
,,ode ��� My Commission Expires -,,Fo'«oa,.
1U1, 4ut4 12i)_
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
5/6/20