HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:y 3l 2o2-_c> Permit Number:
91ro
O
c r� Building Permit Application
Planning and Development Services
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:
4,4 «. 33 c) 7 L,\.,P k)v.e J
wM, 1445 z b
Property Tax ID #: Vc-i>5 .7cA , Ol �3, � �a 3 Lot No. 1 I
Site Plan Name: kf t o e./ / 'fXj tJlr' l,P 4 G\IA►-neQ> Block No. 43
Project Name: \t./ ',-W to l awA C^►^AcIV S
DETAILED DESCRIPTION OF WORK: I
New Electrical Meter �_ Second Electrical Meter Nit
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
Mechanical
Electric
Gas Tank
Plumbing
Total Sq. Ft of Construction:
Gas Piping
_ Sprinklers
_ Shutters
Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof Pitch
Cost of Construction: $ z5c' eo Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name l
Name: ►
Address: ' 3o-7 Nk_,c_L,-,3e
Company:
City: rzA'e`r g State:1�
Zip Code: Fax: P
Phone No. �7-%2..5�9• 3t1`�
Address: 3307 kavtt�ve j
City: 6d ply^ c,p State: IPL_
Zip Code: 3gcl*4 2 Fax:
Phone No 772 5L9 . 31,1c�
E-Mail: P'C
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail K) i4
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: %ot> i4ve #g 2E
Address:
City: �- p► brK State: %;-'L
Zip: 3!��'t'5p Phone -1Z 2 `tL`f 'o i-
City: State:
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/Con r ctor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA /
COUNTY OF
STATE OF FLORIDA
COUNTY OF
Swo n to (or affirmed) and subscribed before me of
Rh sicaI Presence or Online Notarization
thisof 2020 by
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 2020 by
Name of person making statement.
e
Name of person making statement.
Personally Known OR Produced Identification
Type of Identifica 'on . �/�
Produ
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of IN(Signature
ti `f MY COMMISSION # GG 123564 k>
Commission N �: 'cXPIRS Nove�� ,2021
'•• ;pdF; ° bonded ThrUNota7 ftblio UnderWdtors,s
of Notary Public- State of Florida )
Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER REVIEW REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5
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IS 85.6 FEET LONG IS 88.8 FEET LONG