HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO-BE ACCEPTED
Date: "-\ � Per mit Number:
. RECEIVED
F, *14 Y ; = SEP.3 0 2020
y Building Permit Application permitting Department
Planning and Development Services St,LudeCounty
Building and Code Regulation Division COrnmerdal Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772}'462-1578
PERMIT APPLICATION FOR: \_3
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Address: 1 -7 � y '
Property Tax ID#: d l� 5it(; brz);; ��4-�. Lot No.
Site Plan Name: c (1 l O.kl C�i �n G✓d/'r�21� Block No.
Project Name: 0- I)P.n�
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New electrical Meter Second Electrical Meter
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Additional work to be performed under this permit-check all that apply:
_Mechanical Gas Tank Gas Piping Shutters ^v-*dndows/Doors Pond
_Electric _Plumbing. `Sprinklers Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: � j Z�o ' Utilities: _Sewer _Septic Building,Height:
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Name Z 1��-/L 5 j-! c4 �y� ' Name:'
Address: 1 1/0 7. N.
Company:
City: ~r lar +'c State: L Address:
Zip Code:_ 3 Y7 V7 Fax: City:--', - State:
Phone No. `z Z- � :L^ I Ll q Zip Code: Fax:
E-Mail: b 2-6 r”C an t I5-4 Q tno-t l . C.' Phone No
Fill in fee simple Title Holder on next page (if different E-Mail
from the Owner listed above) 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. _
DESIGNERf ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: •State:
Zip: Phone Zip. Phone:
FEE SIMPLE-TiT.LE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER[CONTRACTOR AFFIDVIT:Application is hereby made;tQ obtain a<'per"mit to do the work and installation as indicated.
lcertify,that no work or'instaliation has.commenced prior to the issuance of a permit..
St.Lucie County makes rid representation that its 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:wili,in.allrespects,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,Manother non-residential use
WARNING TO-OWNER:Your failure to Record a Notice of Commencement:rnay'resultjn,paying.twice for
improvernents.to your property..A°Notice of Commencement must be recorded.in'the public records ofSt.i
Lucie County and posted on the jobsIte before the'first inspection.-if you intend to obtain financing, consult
with lender or an attorney before commencing work or recordin our"Notice ofCorn mencement.'
Signature of wnerj L Contractor s Agent for Owner Signature of Contractor/License Hoiden.
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF _ �U COUNTY OF
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
hysical Presence or Online Notarization Physical Presence or Online Notarization
this �} day of .2020 by ;,,this day of '20_ by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification 'Personally Known OR Produced identification
Type of Identifi tion Type of identification.
Produced "L- _ " Produced
A.
(Signature of Nota F� �'' t te'�®fHF �• NIE! SERi (Signature of Notary Public-State of Florida-)
t&te of FlOfide-
:� Commissi Notary Public
Commission No. ;p °c Y Ct7me`efG 207484 Commission No. (Seal)
mnJun. 19 on Expires
l 12, 2022.
REVIEWS FRONT ZONING SUPERVISOP,
PLANS VEGETATION 'SEA TURTLE. ' MANGROVE
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