HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION* TO BE ACCEPTED
Date:Permit Number: a'coo
AUG I
Building Permit Applica'ti.onl-
Co
Planning and Development Services ST. Lucie Co�untyVPermittCli
Building and Code Regulation Division Commercial Residenkial,
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 SO fl� A4
PERMIT APPLICATION FOR: V . Aly 15 - & /V ule_ %1_!5A_t i0 tv
Address: /070e_Xo_',k.0 Uezvsi-w _41(
Property Tak I D #: T. —C/O/— 4000 Lot'No,
Site Plan Name: Block No.
Project Name:
One LAJ 4k,,�
Va
If C. 04 (L vne6
Npw Flprtrir;;l Mpfpr -qprnnri Flprtriral Meter
calewt 6 11
Additional work to be performed under this permit— check all that apply:
Mechanical Gas Tank Gas Piping Shutters Windows/Doors Po'nd
Electric Plumbing Sprinklers Generator Roof .`Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Pe- Utilities: —Sewer —Septic
Building Height:
151M W., W, N
Name 'OAV;� CA, (P '5S
Q
Nam.
Address: 3;X a
City: 4v-c)/.,j Aar I< State: _L/A
e: Fax:,
Zip Code:
Phone No. pqaN.
E-Mail: &Ay)� e AID A5f
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
Company.
Address`: i:
City: State:,
Zip Code:
one No'
E-Mail
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.
7DESIGNER/ENGINEER:.._Not Applicable
MORTGAGE COMPANY:
NotApplicable
me'.
Name:
ress:
Address:ty:
State:
State:
City:
Zip: Phone
Zip: Phone:
I
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
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that
structure. Please consult with. your Home Owners Association and review your deed for any restricti
w build the subject structure
may restrict or prohibit such
ns which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects
.in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
perform the work
The following building permit applications are exempt from undergoing a full concurrency review: r
lom additions,
accessory structures, swimming pools, fences, walls, signs, screen.rooms and accessory uses to anotier
non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in
improvements to your property. A Notice of Commencement must' be recorded
Lucie County and posted on the jobsite before the first inspection. If you intend
with lender or an attorney before commencing work or recordiri '' our Notice of
paying twice for
in the public records of St.
to obtain financing, consult
Commencement.
Signature of own erltssee/Con ctor as Agent for Owner
Signature of Contractor/License
older
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF,
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed
before me of
Physical Presence or Online Notarization
this \N day of <k )1 2020 by
Physical Presence or
this day of
Online Notarization
2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced
Identification
Type of Identification
Type of Identification
Produced L—
Produced
(Signature of Nota ARWete.of P
MY COMMI toN 1 GG 022023
mber ie, 2020
Commission No. `' �d FWI@ Undtlwftm
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•,,fpTia•
(Signature of Notary Public- Sta
( g y
Commission No.
-
a of Florida )
(Seal)
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