HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
O
Date: �i.�� Permit Number:
91r. LUCE
C)
v lrwi �(W' a-- -
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
I PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax IDtt:`J11-V \k\ UO'\U-(J L)
Site Plan Name:
Project Name:
Lot No. 33
Block No.
Nt�Wcc -1 `y o "TAT -C I
New Electrical MeterSecond Electrical Meter
CONSTRUCTION INFORMATION:
Additiflnal 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,
Cost of Construction: $ 2.OciV
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Address:eSZ 1Rpwte' Ci NrJak k
Name:,W%IY> Yl Ptdel.scn
Company: 3
City St UX ae. State: EL-
Zip Code:,3'-fA&P Fax:
Phone No.BL" 2512V gCA52
Address: i qty WirP_
city., Z �t up- Stater
Zip Code: J�AGS3 FaxQ-1 -00O -191p3
Phone NoYk2--P)Q-- 02So
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail (kc 11 j GMCI 1 . ca\
State or County License 1ffS1E AAQLn
If value of construction is 25W 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:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 thepermit 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 u property. A Notice of Commencement must be r cord the public records of St.
tOtie CountyVnd post d q(t the jobsite before the firsyiffspectior If y)�int d to btain financing, consult
(witR lender attor a efore commencing work br recording vo Noti a of 1 ef(cement.
Sign Lure)bf Owner/ Le see/Contractor as Agent for Owner Sign re of Contractor/License Holder
ST OF FLORI STATE OF FLQRIDA
COUNTY OF 1�a2 COUNTY OF _,t �P.
SWRm to or affirmed) ands cribed before me of
Physical Pre ence or � Online Notarization
t is day
yoff�� 220,2200 by �
�� 1.\ 1 la X) Y W L lIC` �]C_�F )
Name of person making statement.
Personally Known L(D- OR Produced Identification
Type of Identification
Commission
REVIEWS I FRONTZONING
COUNTER REVIEW
P„wc state of
eth Bowman
Sworn to (or affirmed) and stAscribed before me of
Physical Presence or—J& Online Notarization
this 23 day of i . 2020 by
Name of person making statement.
Personally Known —@— OR Produced Identification
Type of Identification
Notary Public-
SUPERVISOR
I PLANS REVIEW I VREV EWEGETATION I S REVIEW EATURTLE
cc 800 at Fim
Bowman
Won GG 358675
MANGROVE
REVIEW