HomeMy WebLinkAboutBuilding Permit App.All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Commercial
Residential
PROPOSED IMPROVEMENT LOCATION:
Address: ti , Ct►� [fit jJ�7__ ehJ�n "w L �Jcjrl?
Property Tax ID #: a - - oo, " _ ) L1 Lot No.
Site Plan Name: Block No.
Project Name: 4r\
DETAILED DESCRIPTION OF WORK:
k2lCIU-
c�' 7
New Electrical Meter Second Electrical Meter
CONSTRUCTION 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.
Sq. Ft. of First Floor:
Cost of Construction: $ i S Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 06A LO n
Name:
Address: ["erAn Pv'iYllk �R.
Company: n, 'r� 'u �n
City: JQY7. n �pu State:
Address: t6 i l k 1; �zn » C�-6 U
Zip Code: _ '�cl�(� } Fax: klljCity:
In' cr. State: 4 L
Phone No.
Zip Code: icl ' Fax: P
E-Mail:
Phone No �}� 3-�>q
Fill in fee simple Title Holder on next page (if different
E-Mail SetV'i u_ ; z • �",,
from the Owner listed above)
�tatepr County License5}a4 - Uycls) 21� I
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: Not Applicable
Name:L.6 cG ; Z ;hn 54"i4L_/.V'_yL Name:
Address: 1 Address:
City: 5c- n^ 4-1 t- State: iec , City: State:
Zip: _3tt9 33 Phone `1a �Sr_aZip: 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.
1 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 5t. 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 reco ded in the public records of St.
Lucie County and p ed on the jobsite before the first inspection. If you end to obtain financing, consult
with lender or attorne re commencing work or recqfdLiM youNotice of Corcement.
of Owner/ Lessee/Contractor as Agent for Owner Si u'r 7 of tor/License Bolder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 710Ea �COUNTYOF (�
S orn to (or affirmed) and subscribed before me of Swo n to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization nhysical Presence or Online Notarization
this may of Id r-,t 2020 by this J_-�-&day of 34-[J a&,2020 by
LL"Y)(JaLr � V, Oaf
Name of person making statement. Name of person making statement.
Personally Known a- OR Produced Identification
Type of Identification
Produced
(Sign rf of Notary Public- State of Horida) JENiyp tL fF
�Q�Y Pua;,s ission # GG 32g77'
Commission No. 3z%`i =� • 4 ea °mx 4sgspAsi429,2D23
* � �. p etNotarysari
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REVIEWS I FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Personally Known ' OR Produced Identification
Type of Identification
Produced
(Sign re of Notary Public- State of Florida )
;Commission No.61 3Z8'3 `� r ojPRV P JENNAL. FRAM
— _ aI } Cornrnission # GG 3
* ExpiresAprii29,
SUPERVISOR � PLANS � VEGETATION I SEA REV R LE MANGROVE
REVIEW REVIEW REVIEW � REVIEW