HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE CUm,'LETED FOR APPLICATION TO BE ACCEP1n 1
Date
Permit Number: Zoo1 _ 60 .(
97.
0
a. '= ° Building Permit Application
Planning and Development Services ,j�
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: ��F4v�l o��>�4v� S'�,,chK•�Co/� �� ���
PROPOSED_IM;PROVEM'ENT LOCATI'O;N._._
Address: -70 m4w-
Property Tax ID #: H$rl J 500 CO-7 1 ODv Lot No.
Site Plan Name:
Project Name: q�,/�c�• �v�o �o 10
DETAt1LED DEESCR�I;PTIiON;40 WORK:
�`stP�4r� LjofCie r."C.� pC+ti• rJCaKf
New Electrical Meter Second Electrical Meter.
Additional work to be performed under this permit— check all that apply:
Block No.
_Mechanical
_ Gas Tank
_ Gas Piping
_ Shutters
l0 Windows/Doors
_ Pond
_ Electric
_ Plumbing �
_ Sprinklers
_ Generator
to Roof
Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ B� &M ' C7
Sq. Ft. of First Floor:
Utilities: 2� Sewer _ Septic Building Height:
OWN ER/LESSEE;
'CONTRACTOR:.
Named iLti "Lx 6e!! �L
Name: 16
Address:10 64w [List 14'A S
Company: Conk- S k, I I bon bte/ti-S
City: rT L-. 4.,L State: J�e
Address: 700 s'J i ILIgSK L>-w
Zip Code: Fax:
City: 5�14I' StateAc
Phone No.
Zip Code: VV Fax:
E-Mail:
Phone No `77 /SEE
Fill in fee simple Title Holder on next page ( if different
E-MailPC4pp L �, [dark k• Ski I I CON 1 u c.&6#45 . ��%�`••
from the Owner listed above)
State or County License C 6C-
If value of construction is 25uu or more, a KW.VKUtU I OW& or wrnmcnw1 11onL a �cya+u
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUaPPLEM{ENTAL CONSTRU'CTI,ONt LIEN LA, lINF0 MAT1,0;N
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 I BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
Name:
Address:
City:
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 Countv 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 recording your Notice oT Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA l
COUNTY OF nA %n COUNTY OF M
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this h day ofaP►L-3Q a , 2020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of
Commission No.
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
S% prn to (or affirmed) and subscribed before me of
Y. Physical Presence or Online Notarization
this( day of U v 2020 by
Name of person making statement.
Personally Known A OR Produced Identification
Type of Identification
Produced
(Signature of
•,• b TONIJAWS�BROWN 701IJARE88ROWN
_.; :�,= tNYCtNiIMI��}I#G�332938T Commission N .. ,:� WC01dip3M0863439T
ro. EXPIRES: 16, 2023 EXPIR AprR 16, 2023
�'%3;uFM;g:'�f BondedTlwNoterYPu6NcUti�lwr�s '�•.P. BonQdd
FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW