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HomeMy WebLinkAboutOlson Permit App All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: LCJM PPPP o c o-. :. Building Permit Application Planning and Developrnent 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:Property Tax ID#: Lot No. f `r� +9 Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: T`c L01T e l-q" AaL)Yv-Ira dywmi , s..'o :i rep&-e' 4 KA-C-Cto QQ-u de_Ca(. 4am.. e cam.. cwik L 4 AGILJ Vtn�-I b Cc6e.. '1700 i `Ti#-ar,llc rrj P5L#- 3b �' •kIca New Electrical Meter_ Second Electrical Meter V jE�y SYSL2vn "40 C'4o e­ 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 _1, Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ is; 24�0 Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Edward G ©(so►7 III Name:_C4,VY1C.1-0t1 do ;� " F Address: 4� i✓IY1crAr� (!}`K— Company: by c� CDQSTf�Q 1c� a City: State: F71 Address: 15� 5CS IJ Lz:.uv gAg r' 6A/� Zip Code: 4"T Fax: City:per+ st 1-uc-t.� ate: �I Phone No. 12- 2-01 .554Lp Zip Code:-5AR52 Fax: E-Mail: O i'��a f p�� -ir�,,n Phone No `�12 (�2( =fP2—CD6 Fill in fee simple Title!Holder on next page(if different E-Mail 091 ce,D -PC-rs I I C_ C-©rrn 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. 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: 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 improvements to your property. A Notice of Commencement must be recorded in the public records of St. Lucie County and osted on the jobsite before the first inspection. If you intend to obtain financing, consult with len r attorneV before commencing work or recording our Notice of Commencement. Signatu e of Owner/Lessee/Contractor as Agent for Owner 'gnature of(gntra for/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF � COUNTY OF L I U_ct�) Swor o(or affirmed)and subscribed before me of Sworn,to(or affirmed)and subscribed before me of Phy s — sical Presence,or Online Notarization Physical Presence or—l—Online Notarization this�a day of ,2020 by thi -day of 'plc C 2020 by F'&A"a a sop I ( ( 0_-�i- Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known V OR Produced Identification T pe dentification T��Yypp�zSfd tification Pro uce L— Ir- oduced to (Signature of Notar ublic-State of Florida ) (Signature of Notary blic-S ate of Florida ) Commission No. e Commission No 57N %61l45tateofFlonda Notary ublic tate of Ronda ela Jones Pamela Jonesommission GG 985470 pires 06/15/ 024 or w Ex REVIEWS FR PLANS VEGETATION COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 6 20