HomeMy WebLinkAboutBuilding permit application .'7i4
All APPLICABLE INFO MUST BE40MPLETED FOR APPLICATION TO BE ACCEPTED Date: � �t'� Permit Number: 2 0Q [(� v/'}
O=p�
9`F-.L UriL.CL
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:
PRORO$ED IMPROVEMENT LOCATION:
Address: ��1�J � e�� v csa 6
Property Tax ID#: On10 C'Q -1 Lot No. � a
Site Plan Name: Block No.
Project Name: tt V
DETAILED:DESCRIPTION OF1NORK. �� 1(Q, I f ► 0cF;r-.. ems[ S `
New Electrical Meter Second Electrical Meter
CONSTRUCTION.INFORMATION
µ
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank —Gas Piping _Shutters —Windows/Doors _Pond
Electric _Plumbing _Sprinklers _Generator Roof s,l�- Pitch
Total Sq. Ft of Construction: � 000 Sq. Ft.of First Floor:
r1 Cost of Construction:$ ,9 a D Utilities: —Sewer Se tic Building Height:
'QWNER/ SE E CORITRAC O j
r
Name 1'�y 1 ke,1 Ch!'u vim. Name: SI1
Address: �2 It5- M S/�s� 1 ems-" Company: S�f't'�e r c l JTer�. R a -l=�e
City: ''S C Stater Address S2c� o�Metli.�� av R'
Zip Code: 3 Lf q Fax: A City: Gi<f State: �I
Phone No. -112- 'f' & Zip Code: 3^Y�-� Fax:
E-Mail: Phone No 172- 33 ( ` 3
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License CCC 13 z 6 117-0
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.
1
1 ty
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:
i
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
improverrignis to your property. A Notice of Commencement m e recor a in the public records of St.
Lucie nt an posted on the jobsite before the first in! Ion. If you inte to obtain financing, consult
wit end o attorneybefore commencingwork or rec din our of ce of Commencement.
t
Signature of er/Lessee/Contractor as 77g—en—rf orewnq er Sign atur or License Holder
STATE OF FLORIDA STATE OF FL A
COUNTY OF J I\0i�n COUNTY OF mA�n
Swofn to(or affirmed)and subscribed before me of Sw/Physical
o(or affirmed)and subscribed before me of
✓✓✓ Physical Presence or Online Notarization Presence or Online Notarization
this day of kgr,�,s V 2020 by this o2( day of uS 1— 2020 by
Name of person making st ement. Name of person making s ement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification ype of Identification
Produced NOtAry Public State of Flonda roduc .rrt'YI Notary Public Slate of FI
N
M, ela Frantantoni Carmela Frantantoni
,1 My Commission HH 0�820 �i • My Commission HH 008 2
y ` Expires O610412024 �iaw� Expires 0610412024
(Signature of Notary`1Pubc / (Si ature of Notary Public-State n
a
Commission No. rii' ��b (Seal) Commission No.�- l- Ooboo o (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
i
I i
i