HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO -BE ACCEPTED
Date:
- Permit, Number:
- I
RECEIVED
I
SEP 17 2020
Building Permit Application Pe mitSt. ing-LuciCounty
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Commercial Residential
Phone: (772) 462-1553 Fax: (772)'462-1578
I° I PERMIT APPLICATION FOR:
Address: 12,11z Se Lc./'l •11
Property Tax ID#: jq ! 0 21 1"
Site Plan Name: /od�(C ee��c�ti_- Lot No.---.
Project Name: _ /� it Block No.
New electrical Meter, Second'ElectricaI NI
Haaitional work to be performed under this permit- check all that apply:
_Mechanical — Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction•
_ Generator
_ Windows/Doors — Pond
Roof pitch
Sq. Ft. of First Floor:
CoAt':of Construction: $ l�'QOCJ • oc7 _
Utilities Sewer._ Septic Building Height:
Name
Address: 2-(e. Can-�iD
City: irf Sf �v c �L`
y State: _
Zip Code: S Fax:
Phone. No. 72 2 5 a I f 7 3 Z
E-Mail:
;Fill, in -fee simple Title Holder on next page (if different
from -the Owner listed above)
Company,: ZTC � nr1CC
Address:,
'City: ' S
c"`Y State: �L
Zip Code:' 5d/ ? Fax:
Phone No 72 Z- Zrb 17
E-Mail 7r(--o Cc,$A(f
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.
Not Applicable
Name:
Address: State:.
City:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _
Not Applicable
Name:
Address:
city: •
Zip: Phone:
MORTGAGE COMPANY:
Not, Appllca
Name:
Address:
State
City:
Phone:
�— Applicable
BONDING COMPANY: Not
Name:
Address:
City:
Zip:
- VIT: Application is hereby made to obtain a permit to do the�wiork and installation as indicated.
OWNER/ CONTRACTOR AFF1D;
that°no work or installation has commenced pnorto the issuance�of a perms
.l' certify k. .
b laws or and covenants'that may restrict or prohibit such
e Coun makes no representation that is.ge St�goclat on4ru esauyh,onzethn pc6ve ants' Ion whi hto emay,app structure
St.,Lucl, applicable Home Own
which is m con lict.with any h y ' b perform the work
structure. Please consult with,you"r Home Owners Association and revs agree that 1 will in all respects, p
In consideration of the granting of this requested per-mit, I do hereby g
in accordance,with the approved plans, the'Florida Building Codes o ng a full conrid-St. Lucie our .ency Amendments.'e e room additions,
The following building permit applications are exempt from underg
;structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to anothe a on -residential
for
use,:
accessory. mencement must -be recorlt�np y g• .
WARNING TO OWNER: Your failure to. Record a Notice; of Commencement may rc , _ 1 m5the pwblic records of:St:.
improvements:to your property A`Notice of Com
' and' st ' on the jobsite before the first lnspecdej
tron If'yo ,m nd to obtain fi"nancmg, consult
Lucie'Courity a e before commencin work or recordin o. ' ti a of Commencement.
with lender or_a
I
Signature of 0 er/ Lessee/Contractor as Agent for Owner
STATE. OF FLORIDA
COUNTY OF•: , ., .
Sworn to (or affirmed) and subscribe —onlineNotarization.fre
me of
Physical Presence or � 20—by
this dby of
Signature Con ractor/License Holder .
STATOF FLORIDA
COUNTY' OF 's
Sworn to (or affirmed) and subscribed before me of
Online Notarization
Physical or J 20_ by,
this day of
Name of person making statement:
Name of person :making statement. OR Produced•Identification
Personally Known
Personally Known _ OR Produced Identification Type of Identification
Type of Identification produced
(Signature,of Notary Public- State of Florida) .
Commission No. (Seal)
REVIEWS FRONT ZONING
COUNTER REVIEW
PLETED
�Q ,4 � CD
3 2a
.a - m-�
N: O m
(Signature of Notary Public -State of Florida)
° z
(Seal)
Commission No.
T=
d3ixam
tT
PLANS VEGETATION ' SEATUF REV EWLE
REVIEW REVIEW
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