HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTkiJ
Date: 'aa z,d Permit Number:
° Building Permit ApSr plication AUG 2 0 2020
Planning and Development Services Lucie Count
Y, Perm,
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 IMPR'OVEMENT.=LOCATIORI: r°
_ K -
Address: /�/ yl�' 13 •mac IQoC ram, GG .,983
Property Tax ID 9^ 47t0" e0,1,7—ad 0^ T Lot No._�
Site Plan Name: lilt" �Q/!.K/ GkL/,�1_ fR�G . Ci Block No.OF
Project Name: n_____ Q
New Electrical Meter ' Second Electrical Meter
r, c
i CONSTRUCl'ION; 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: �'i, &_ Sq. Ft. of First Floor:
Cost of Construction: $ dd . e� Utilities: —Sewer _ SepticBuilding Height:
OWNER LESSEE
... ... _ . CONTRAR CTO
Name
Address:
City: p�_� � .G[�C� State:, l
Zip Code:.V�m�_ Fax:
Phone No. 72al � �dmy
E-Mail: DOPIA� AN G1Y1�'ilfL • Cdij'!
Fill in fee simple,Title Holder on next page( if different
from the Owner listed above)
0
City:.y}D Stater
Zip Code:.. RM42 Fax:
Phone Nc I 'S�aZ'd"7
E-Mail At& f ee-ow
State or' County License C
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:
JKNot Applicable
Name:
G
Name:
Address: /
� D/
Address:
City:
State: , 4
City:
State:
Zip: 4 § JIM Phone 94//
_:19/-;��o
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: Yourfailure 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 lende*or an attornev before commencing work or recording your Notice of Commencement.
STATE OF FLORIDA `
COUNTY OF ST Liu �
STATE OF FLORIDA
COUNTY OF 4ff - WcA c-
Sworn to (or affirmed) and -subscribed before me of Sworq to (or affirmed) and subscribed before me of
✓Physical Pres or Online Notarization ✓ Physical Pres nce or Online Notarization
this � ce day of vST' 2020 by this _ff day of 2020 by
�• T� -S i� `�� � w S I, �I�' Ir-�,, 5 y � K S
Name of person making statement. Name of person making statemMU
Personally Known ✓ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
SE EYES
of Notary 'o 1ppri 40070 Si nature of Notary Public- S t, For
(Signature ry �'"' EXP E August 30, 2021 (Signature
g ry ;y ,� MISSION iF GG140
/�+� �1 0«� EXPIRES August'30, 202
Commission No.6C. I Commission No.." d0 (Sea)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW I REVIEW I REVIEW REVIEW
DATE
DATE