HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE (INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number--- Z0-0-8--
0
Building Permit Applicati
Ar
n �rJ 2020
Planning and Development �< ,�
9 P " e+ui i^!� ! 1i;7 P,7-IJ "'FP S�nt
Building and Code Regulation Division Commercial ResidentialJoAC
COU nf,.1 FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
1
PERMIT APPLICATION FOR:
PROP.OSED,,I;MPROVEMENT.LOCATION ;.
Address: ► o`7 as h I�r l�rt 4 ,ax�h
6-6
Property Tax ID #: L16 I I ^ '-iO& 00 `5
Lot No.
Site Plan Name:
Block No.
Project Name:
DETAILED DESCRIPTION OF WORK: �
-
1, { }
,.
12tV,A0U-f 0 (b deG
Ad c
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New Electrical Meter Second Electrical Meter
.CONSTR(j�CTION.INFOR'MATION
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: $ .00 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:,
CONTRACTOR:::.,
Nam ol.ci S
Name:.�'�rPvU,i���
�A#n!!�e) z::,
Address:
Company: j2 ExfE'Yi(Sr5
.1'AC
City: 01[ 114r.� Y1 , Stater
Address: J201 o'
rza --e
Zip Code: lS,QQ_71 Fax:
City:
Stater
Phone No.
Zip Code:'
Fax:
E-Mail:
Phone No %%,;9-'0 7 =3=
QCoG_1T
Fill in fee simple Title Holder on next page (if different
E-Mail i)'L�o c� I iJl �K%ri'oj'
S . C0137
from the Owner listed above)
State or County License 0=,60—
/,;; /
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.CONST.RUCTfON LIEN [AW {N;FORIVIATION
4-
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 Count 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
t..P+h lonrlcr r,r nn ntfnrnav hnfnra rnmmanrina inrnrk nr rarnrdino vnur Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
S1�gnatufe of Contra or/License Holder
STATE OF yj q C I
7
rJ-`L
COUNTY OFSTATE OF ORIDAs ) u � l -e
COUNTY OFORIDA�
l�
Sworq.to`(or affirmed) and subscribed before me of
Sworn_ tp (or affirmed) and subscribed before me of
Prese Online Notarization.
&, Physical Presen a or Online Notarization
this JL day of tt 2020 by
��riysical ce or
this —4 day of AW1,A 12020 by
a�n � \4 �
Name of person making statement.
Name of person making statement.
tl OR Identification.
Personally Known 'R Produced Identification
Personally Known Produced
Type of Identifi t'
Type of Identification
Produced
Pro ced
21a
Signature of N t,ublicfAgfAr1
(Sign a of NotaryPublic- State of Florida ).
lip. ' ' commilsW 0 HH,031O60
Commission N� ' �18�MR[)
r
Commissi �fo►�;�+ JOSHUAS.ALBERICO950 (Seal)
"a Aupact 16, 2024
REVIEWS'
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SUPERVISOR
PLANS
VEGETATION
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DATE
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COMPLETED
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