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HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 061t) , d iy— 940 RECEIVED o l�1 15 OCT U 8 1010 Building Permit Application Permitting Department Planning and Development Services St. Lucie County i� 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: Z 6-` 4-if< A-< /`-A 1 C Property Tax ID#: /Y9JI 174o� /��s GGG- Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: 2—Cl CkW AIX Ai AL lily/ 0 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 ✓Isfumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ R©O , QU Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name C C Nam • <- Address: `�3 Ce '� Company: bl� ti City: State-14J Address: C,, A �­- Zip Code: //S Q6' Fax: City:, fly-��c.y Stater Phone No. 7~l0� -� �� Zip Code: ��11r'�3 Fax:�o?'7�0^7-M E-Mail: Phone No '7 ,,�-3�- y�/�/ Fill in fee simple Title Holder on next page( if different E-MailC�A/U)V<(J, .lc�v� i�S 007-71, Air from the Owner listed above) State or County License Lfvae of construction is 2500 or more,a RECORDED Notice of Commencement is required. e 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 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 with lepcler or an attorney before commencing work or reaQxdin our Notice of Commencement. Si ature o caner/Lessee/Contractor as Agent for Owner 'Sigirfature o ntractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of Physical Presence r Online Notarization Physical Presence or Online Notarization this day of D _,2020 by this�day of d 2020 by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificat' n Type of Identification Pr du ed �i Produced #X el (Signature of Notary Pubr*Stateof Florida) " (Signat re of Notary Public-State Florida ) a L[Kev. mission No. (Seal �''°�• Commission No. (Seal' o a 2 �n � 3 �m �d n3 D n fA VIEWS FRONT ZONING 30eEAV R PLANS VEGETATION SEA TURTLE e m E COUNTER REVIEW d Aph REVIEW REVIEW REVIEW W4 E rno BZW Nx �o� EIVED ' �c D w`O E a T o PLETED m N