HomeMy WebLinkAboutBuilding Permit Application All,APPLICAIBLE.INFO MUST BE COMPLETED FOR APPLICATION TO-BE ACCEPTED
Date: Permit Permit_Number:
,! �^,,
it # :ECEI 4/E /
Building Permit Application. UP 2 9 21,210
Planning and Development Services
Commercial ReSi ST: ' Coun , ermitting
Building and Code Regulation Division 1 1
2300 Virginia Avenue,Fort Pierce FL-34982
Phone: (772)462-1553 Fax: (772)`462-1578 t
PERMIT APPLICATION FOR:
�. r,t5 R` `•_. n
Address: 2 d�^ I7u-�-� � h uP �6 PfcQ �� yq(?- 'l YIr too
PropertyTaxiD#: -����1��) �O�vO� U��` I Lot No.
Site Plan Name: Block No.
Project Name:
I
h. ,11 a..
}
ue~ fv �f ILI,r-Ce
1
New electrical Meter Second Electrical Meter
t r.+ .,+s' �Y Y � 57:1.Rr.&`�C•'.ST °� A'r+:y51,a.�+ _ �'»� ?,�A�l-ri�'x,i .meq'�..y:v'..ate-�,!.�9 1�,�'.,-,,•i uF",;,.:,: v' GE+"k:�.i$�
i
Additional work to be performed under this permit-check all that apply:
_Mechanical ^Gas Tank _ Gas Piping _Shutters Windows/Doors` Pond
—Electric Plumbing Sprinklers ,Generator _Roof t Pitch
I
Total Sq. Ft of Construction: Sq. Ft. of First Floor: I
Cost of Construction:$ 10"01 _ Utilities: Sewer —Septic Building Helight:
•y�.�.—,+-.,+.r.�., .»:." .av,T�. 9 'S 1 -C"tg'":•':.M1 t,fi4"v 'taxa ..xa Yh°i4`^;wiv .-ms•m ix4' v'M�711"uts•� .,i I.s.rQ ipr,.'x.`"i;.'y',,1.�h ..1�w•ff- }i-• •;5 ."'3., +; J
('� 5 .;'`_'�t,'.y ..hh�•u�' •. ��115 ,y�n-q�'i;'"5"�U�l..�+C Gln: 6 vii.:S+ V_"_: � 6 >.�.. 4a"�+.�'„v•. .,- ~5't=f�'3:i. "♦St:
a1✓_.• •��,e, <:T "1..,.n c, �{�{><.,t�F;;� ;s sr`c Ojc{ syn, •1,.'"4.-.�;`sy'}j'
>'ti',��..� it"s1�tk4 't. c3':.3::•'�§t.l�V .tf'.��:ni•'b't?s�:«Si`.+a+Wq!'?..'\:...:,wt:zris``:'�r.i'+.°,a.... ...�7s r~..:
Name w ! �` j Name . RPh &
Address:`t?�`�,�':'`�' Company:'; .1/'�C'i�P � 6bn4-m!C'h'7rzz% '�2 V-Uj
State:..Fz " address: ;
2ip.Code:,' 3-V�.b- _ Fax: City: Sfiate:_)�
Phone"«o: Zip Code: Fax: J F
E-Mail: J w%. Phone NoC-7`Z.2, 71
Fill in fee simple Title Holder on ne t page ( if different E-Mail �r7c -2.'" vl4 r�r. �?5
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.
.DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name --
Address: Address:
City: State: City: State:
Zip: Phone " Zip: Phone:
FEE SIMPLE TITLE D
L i E HOL ER. �Not Applicable . BONDING COMPANY: •Not Applicable
Name: Name.-
Address:
ame: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.
1'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 accessoryuses to another non-residential.use
WARNING TO-OWNER:Your failure to Record a Notice of.Commencement may result in,paying,Wce 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
w' e der or n atto-svie4efore commencing work or recording our Notice of Commencement.
/ 7
Sign r e j Lessee/Contractor as Agent for Owner Signat e o r/License Holder .`
ST E OF ,L IDA ST TE OF IDA .W
COUNTY. COUNTY OF '
Sworn to(or affirmed)and subscribed before me of ' S orn to(or affirmed)and subscribed before me of
'_Physical Presence or Oniine Notarization sical Pr 1 r, On• Mation
this—a` day of Sg � 2Q�'� by this �day of( C
Namof pees n making statement. Nameof persbn making statement.1
Personally Known OR Produced identification Personally Known OR Produced identification
Type of Identification '. Type of Identification.
Produced �liD C Produced
(Signature of Notary P bll., (Signature of Notary Publi -State of Florida)
o.Y..., i
.�aR`'"•' 4% DEANNA MARIE GIVENS s
x ISSION#GG 022023 ue-. s� KE LAPLOT
Commission No. a. , ; ��f commission No. .••'4'6
-'; o
"PIR December 16,2020 ?°; Notary Public-State of Florida
«......"' Bonded Thru Notary public Underwriters P i_� o"s
Commission#GG 951670
Ma�y Comm Expires Feb 24,2024
REVIEWS FRONT ZONING SUPERVISOR PLANS' VEGETATION 61rii t roux t r n.
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIE
kev.
D
-
ETED.