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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ` �°� `aa Permit Number:ST. LUCI SEP 2 J20 ° Building Permit Application Sr' Lucie County perm. . ng Planning and Development 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: 3©`�o es Q - 02 S t F• 3��5 Property Tax ID#: 3�a T 7d oZ oZ o� O O O Lot No. �r Site Plan Name: Block No. �e S— Project Name: L-ouy s e- DETAILED DESCRIPTION' QF' WORK: 14.40 J 2- 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 Roofa�Pitch Total Sq. Ft of Construction: a?7 C-0 — Sq. Ft. of First Floor: Cost of Construction: $ Utilities: _Sewer _Septic Building Height: /CD OWNER/LESSEE: CONTRACTOR: Name S Name: Address: 361D e Ale_ Company: R / LL City: F' T S State/`G� Address: Zip Code: Fax:7 9 ��- Fax: City: CT711.1 1"4" Stater Phone No. vW s--?O- �, /3 Zip Code: 9 5-3 Fax:, E-Mail: �'N'` Phone No Fill in fee simple Title Holder on next page(if different E-Mail Q&V,0 .(a Y-P2-�• Con from the Owner listed above) State or County License C C C 1 :? 3,13 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 thepermit 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 Coupty and posto on the jobsite before the first inspectio If you intend obtain financing, consult with londerfor an attgfhey before commencing work or recor our Noticeof C,6mmencement. Signature O er ssee/Contractor as Agent for Owner Signature o Co tract icen a Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF Swor o(or affirmed)and subscribed before me of Sworn °dor affirmed)and subscribed before me of 11-12kcal Presence or Online Notarization �P Ical Presenc or Online Notarization this ay of SoT, - .2020 by this day of 20 0 by voki, IF Name of person making st tement. Name of per on making statement. Personally Known OR Produced Identification Personally Known -_"'�'OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Nota =E1 (Signature of Notary Pub' - t t r' orida Notary tbate Ct FloridaCommission No. FA651 Commission No. Andre" dy M 96 �p My Comrrf"on GG 347651 je�t;a Expires 06/2312023 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Te-v-.5/6/20.