HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Ntui
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Building Permit Appl
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
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031 2020
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PERMIT APPLICATION FOR: �.
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Address: 7_5 2 ``31 M 11V 1 C [ lQ
Property Tax ID #: I `I Z 5 70 % 0036 DO 0 14 Lot No.
Site Plan Name: 14 ALAJ KI N S Block No. Z
Project Name: 14 A MO /VS
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New Electrical Meter Second Electrical Meter
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:
Cost of Construction: $ 37. 5DD . 00
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
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Name MICNAO, HAWK(A S
Name Ff-&VY- P_QS50
Company: FWLY 491)OU /NC
Address:257 -bmtal C(2
City: lT.0 e&L State: 5K,
Address: M c%N NACM9 13LVD
City: Pn,eT ST L1 c (E State: Ft
Zip Code: 3 L1q LfR Fax:
Phone No.
Zip Code: �ZCf q M— Fax: -772 785'95'sY
E-Mail:
Phone No 779 8r/ff P/5--L,
Fill in fee simple Title Holder on next page ( if different
E-Mail J5AA"K G FAM (g19WJ KfC . C#0v 1
from the Owner listed above)
State or County License0_PC O�5lo9a-�
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.
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DESIGNER/ENGINEER. _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: kL 560 �71 'r�/f r�tp
Name:
Address:/.IQq In VVBDE WAY
Address:
City: State:
City: PALM 861ItIt C1 AfL aX State: _ —L
Zip: _3 I9Phone�SW_
Zip: Phon
FEE SIMPLE TITLE HOLDER: __,,,,,t'Tot Applirable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: P e:
Zip: Phone:
OWNER/ CONTRACTOR AI4IDVIT: 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 commencing work or recording vour Notice of Commencement.
Signature of Owner/ Lessee/Contra for as Agent for Owner
S'gnature of Contractor/License Holder
CS
-STATE OF FLORIDA
TATE OF FLORIDA ��le
COUNTY OF
COUNTYOF SST iDIACiNSwg�to
(or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before
e� Physical Pres ce or Online Notarizatio c�.�
N 2020 by ��
.�Ph sical Presence or Online Notarthis
day
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day of
this of c
of person making statement.
Name of person making statement.
Personally Known /OR Produced Identifica 'o
Personally Known �OR Produced Ident
Type of Identification FL D(, a
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Type of Identificatioq..
Produced
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Produced
Signature of Not ry Public- State of Florida)
(Signature of Notary ublic- State of Florida )
Commission No. J21(Sea])
Commission NoC4 �O (Seal)
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SUPERVISOR
PLANS
VEGETATION
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MANGROVE
COUNTER
REVIEW
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