HomeMy WebLinkAboutBuilding permit app All APPLICABLE INFO M1.18T BE COMPLETED FOR APPLICATION TO BE ACCIEPTED
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I Date: p Permit Number: 3001
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Builidinsy Permit Application
Planning and Development Services
Building and Code Regulation Divislon Commercial Residential
2300 Virrlinia Avenue, Fort Pierre FL 34982
Phone: (772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR: 10+1'on
-P�R, iPOSED IMF ROVENI,ENT LOCATION-,.,
Address: Q0( Any 7-)nw
�Propert:Y Tax ID#: 1�4 0 L4 LW - on I - Lot No.
Site Plan Name: Nock No.
,Project Name: ':S)c-c+ron-'3
DETAILED DESCRIPTION OF WORK:
w- nu i�cncc
S
SCAP . C110SIM-A-0 C-00C .
New Electrical Meter .—Seco--n)d Electrical Meter
7 77,
LCONSTRUCTIONINIP MATION:
Additional work to be performed under this permit—check all that apply:
Kilechanical Y Gas Tank Gas Piping Shutters Windows/Doors Pond
Electric Plumbing Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft, of Ffrst Floor:
Cost of Construction: $ 00 Utilities: —.Sewer _Septic Building:Height:
OMERAESSE .. CONTRACT.01-1:
Name Name:
Compal Aciclress;i U30C
City: V; rf C' State: Address:
Zip Cocip a Fax: City: Stater:
Phone No. I;),) --,Kn cr ) Zip Code: Fax:
E-Maill: lrL G) alrone No 'r1a) �;PNQP — C% A
Fill in fee simple Title Hdlder on next page if different E-Mai I J. hn t GOT I
from the Owner listed above) State or County License 314V5 .
if value of construction is 200 or more,a RECORDED Notice of Commencement Is required.
'LIf value!of HAVC is$7,500 ce moire,a RECORDED Notice of Commencement Is recitjinsd.
sU 't'I lE MENTAL CONSTRUCTION LlEfu Li ' INFORI�,1�11"IQIiJ'.
r
DESIGNER/ENGINEER: _ ,
— _Not Applicable MORTGAGE COMPANY: !_ Not Applicablie
Narne:_ 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,Citi---
y: City:_
Phone:. Zip: Phone: —
OWNER/CONTRACTOR AFFIIDVIT:Application is hereby made to obtain a,permit to do the work and installation as indicated.
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 frorn undergoing a full concurrency review:room additions,
accessory structures,s'Nimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Comnnencoment 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 ccmmencing work or recordin> our Notice of Commencement. �
Signature of Ownery Lessee/Contracto a Agent for Owner Signature of Contractor/License Holdeb
STATE OF FLORIDA STAn OF FLORIDA
COUNTY OF S4 Iucie _ COUNTY OF Sj- . LLKJ-c
Sworn to (or affirmed)and subscribed before me of Sw rn to(or affirmed)and subscribed before me of
Physical Presen-�e or —Online Notarization V Ph sical Presence or Online Notarization
this boa r2lay of_ff.W 2020 b�� this ay of JLAIW _ , 2Ci20 by
Name of person making/statement. Name of person making statement.
Personally Known Jv OR Produced Identification Personally Known �1 J OR Produced Identification
Type of Identification Type of Idetntificatio'n ~I�
Produced Produce _
(Signature of Notary P I Y , JR. (Signature of tJotary
GAMES t�p� ' ►;ate dRf�CddaC�iOMES, JR.
i l o.Notary f'•,blic-State of Florida
G,, otal i,Public State of Florida C nmies, GG 966763
Commission No._ �' om�;-2�.bn i GG 988783 Commission I G t,,� „4A'4Jb
P ., w ' •: n Expires
My Commission Expires ''�����"` March OB, n Ex
24
March 08, 2024 _
REVIEWS FRONT ZONING SUPERVISOR PLA14S VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW1
f`f DATE -'
f RECEIVED — -�
4 AX
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�LETED — _—
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