HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: / B 'ZO O Permit Number:
C�SEP10'0�
7"0 0
:_>°D Building Permit Applicatio
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Address: At'107 e/, Hwy AA
Property Tax ID #: ��11l1{11 " %�j' DODD - poo ® Lot No.
Site Plan Name: 0C,64N 11019;VWX A10971 006 4 Block No.
Project Name:
.DETAILED DESCRIPTION ,OF WORK:::.'
r
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: $ 30,060. oo Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:,' :..;
CONTRACTOR:
Name0ceeu n
t "6U+- t' fm AA MI rN tQ, ry-% ASsil.
Name:
Address: �3 207" r�L
City: e VkA Adgi State
Zip Code: 329`0 Fax: `1 %a�;7o� Y300
Phone No. 7 c} �o- ��l�3
_�d64Qr�s/%f%Qe
Company: Cory
,S'%Q�/L'�IJQe.-
Address: g.Q.
City: 19jeeec 6P.e State: PL
Zip Code: 3��i? Fax:
Phone No V
E-Mail: \ Ll.�l.2.� �,bl
+
"C1 %'1� � 1, 4Sv�
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail S"?QdC%/QCd✓�dL•f
State or County License C&CD41at?
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.
SUPPLEM.ENTAL•'CONSTRUCTION'LLIEN LAW INFORMANTI'ON: -:
DESIGNER/ENGINEER: _
Name: AL. "1AXkR1N& IVC ►
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: Zaio 37 &a.
Address:
City: VA-Ro AfAC,4
Zip: SmI&C Phone 772 Oq
State: -Z-
Ix5"7
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPANY: Not Applicable
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 posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attgrney before commencing work or recording our Notice of Commencement.
Signature of Owner L ssee/Contract as Agent for O ner
Signature of Contractor/License Holder
STATE OF FLORIDA
\P\ e"r
STATE OF FLORIDA
COUNTY OF ay-."
y,
COUNTY OF S' :ace e
Sworn o (or affirmed) and subscribed before me of
ical Pres Online Notarization
Swor to (or affirmed) and subscribed before me of
to
Presence Online Notarization
c or
A
day 2020 by
or
day 2020 by
this of
this -1y of %0mAee
Name o rson making statement.
ment.
Name of person maki7OR
' Personally Known f a
Personally Known Produced Identification
Type of Identificati JULIE BARRETT
Type of Identification
Produced �„ �•: • ; : Notary Public - State of Florida
Produced s
9 �issior• a GG 243242
My Comm. Expires Se, 28. 2022
Bonded throw h Nair :. •
(Signature of Notary u ic- o
(Signature of Not FSt�MM
�� Notary Public State of Florida
Commission No. (Seal)
Commission No. Shannon O.D I
ommissio 8323
O y Expires 08/13/2022
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