Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f Date: Permit Number: P RECEIVED OCT O 12020 R Building Permit Application _ Permitting Department Planning and Development Services St. Lucie County 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: PRO OSE &MViTO&T 10 90I N: Address: I A tKP-T_ ��1166 PropertyTaxlD#: Lot No. Site Plan Name: AKSM 06EAT Block No. Project Name: (Al-71T _ DE AILED DE�S�RIPT ON QF WORK: C ove' 71 �x rs7Ll� 6 177 _ pAwo, r" CALL= wa-d 61 (2 ALL ill TF, New Electrical Meter Second Electrical Meter CONST' IJCT N SU@0MJ1 TION• 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 Pitch Total Sq. Ft of Construction: ,i L Sq. Ft.of First Floor: ,v1 CCU_ Cost of Construction: $ 0� Utilities: _Sewer _Septic Building Height: OWNER/LE�S�SEE: C(3NTRACTOR:Name yry (ti'ub Name n: � N ...,,. .. ,�A,/t/1.y :Address: 13 2 f v6 Company: /rc�f ,City: FT,, p1me-G State: FL Address:1?43 �f.(1� i:✓fllsl�'�'�1��71��41� Zip Code: $61 R Fax: A,' A City: P/9 C �`(-If' Sate: FZ Phone No.' ��c .���.�'" `S Zip Code: CI�� d Fax:." .. .�.. E-Mail: L! Phone No 6 Y Fill in fee simple Title Holder on next page( if different E-Mail Cl0t'e-l^o4 '2 Aoi_ 01 from the Owner listed above) State or County License CkC fS_S W ,� L e 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. INa PLEM ANT L CONSTR+U TION LIEN LAW iNFORMATi• N:SIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable me: Name:__ Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE H LDER: _KNot Applicable BONDING COMPANY: Not Applicable Name: Name: n/ld 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 lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Hol e STATE OF FLORIDA STATE OF FLORIj� COUNTY OF COUNTY OF �"1 Sty' /TGc GPIJ Sw n to(or affirmed) n u cribed before me of Sworn to(or affirmed)and subscribed before me of hysical PreQr Online Notarization Physical Presence or Online Notarization this day of l 20� 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 Identifica ion Type of Identification Produced L Produced (SignatYre C (Signature of Notary Public-State of Florida) KAREN S. NIELSEN Commission B`v;State of Floocommissirs# GA�207'484ublic Commission No. (Seal) My Commission Expires REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW. REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 5/6/20 FLORIDA JURAT FS 117.05(13)— Effective January 1,2020 a" �ti;t��.;����•��;��t" �3n�'�E�sN '���t' E �.;" � �i;`�`;'s� r?���P "�z.3�':�i?�s" �r State of Florida County of f��` ,II Sworn to(or affirmed)and subscribed before me by means of ysical Presence, —OR- 0 Online Notarization, this-.., day of by Day Month Year 6✓GiA Z Awl No f Person Swearing or Affirming Si cure o Notary Public—State of Florida Name of Notary Typed, Printed or Stamped ❑�roduced y Known ,•o�Y��''' JENNIFERDOMINGUEZ 's,:-0k Identification ,,�„ �a; � Notary Public-State of Florid 3A: Commission"GG 345242 My Comm.Expires Jur.16.2023 Type of Identification Produced: Place Notary Seal Stamp Above OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: 64 le/�+ Document Date:� l?`d Number of Pages: Signer(s)Other Than Named Above: _ -- •�'��" "s�"�`s�:,��'a'r.����. '��*aka -�'-,ru�� a.�z.£�s��IDFs �i3'�:. r ©2019 National Notary Association M1304-10 (01/20)