HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COM1*ftED FOR APPLICATION TO BE ACCEPTED
Date: v rJ Permit Number: 3
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:
Address:
�`�t��,'�.
PropertyTax ID #: 3�1-0 \ ^ 6yc� - C70� - OQU15 Lot No. US -
Site Plan Name: Block No.
Project Name:s'NED
DETAILED DESCRIPTION OF WORK:
SEED USED C--oQ. AN6AoeS -N ZT- SFtEJn SkTs ONS
0-0m CIZET F 4- to * l
New Electrical Meter
Second Electrical Meter
-CONSTRUCTION I NFORMATION:
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: Sq. Ft. of First Floor:
Cost of Construction: $ `r(� Jr3�5 . S Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
'CONTRACTOR:
NameC(AP-IST0PPER_ 6EIZE'-&TRRAT
Name: t� A
Company:
Address: �5'�)00 INl7`4N (ZtVEP— DP,
City: F0{- T- P (CeCC State: _E,
Address:
Zip Code: Vq 89, Fax:
City: State:
Phone No. 9Gq-Ci0 (_ Ua0(D
Zip Code: Fax:
E-Mail: Cite-S 1 I RPATT °0 GMA 11_ . COM
Phone No
Fill in fee simple Title Holder on next page ( if different
E-Mail
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.
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 attornev before comrriencine work or recnrdina vnim Nntira of rnmmant-aman+
�e�v� c-7fiG
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA �r'
COUNTY
STATE OF FLORIDA
OF lJl
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence o Online Notarization
Physical Presence or Online Notarization
this - I - day of 7n20 by
this day of . 2020 by
S rK-Q, -
Name of person fnaring statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification ,(�
Type of Identification
Produced% 11J1
i
Produced
(Signature of Notary P
(Signature of Notary Public- State of Florida )
CLIN VA U.G H N
Commission No.
�PpY P(,B
State of Florida -Notary Public
__ ►= comrj lVn # GG 270079
Commission No. (Seal)
My Commission Expires
October 22, 2022
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Rev. 5/b/20