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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �j Date: Permit Number: ,0 l �3lJe sno b�1C�DC REC VED . Building Permit Application pepanenr • in9 Planning and Development Services Building and Code Regulation Division Commercial 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Per St. uCie �O tv Residential I PERMIT APPLICATION FOR: �( { min (Q I �l, ,,�,��,`� qu'A cc _ PROPOSED�aI'IVIPROVEIVIENT, LOCATI Address: �� �� L.U/�L �iY�C. �� �tP u Property Tax ID #: ���� _ ©' �, Lot No._ Site Plan Name: Block No. Project Name: DETAfLED DESCR' c` Ele, CArt•/ q0 OF WORK "fi e?0/ D-1 -. J/JL 1 New Electrical Meter Second Electrical Meter CONSTRUCTION INFOR'MAT[ON, 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: Sq. Ft. of First Floor: Cost of Construction: $ DID Utilities: —Sewer —Septic Building Height: OWNER/LESSEE ;t° „; CONTRACTOR.' Name �li�rn Dcn6X r,.11b2c Name: 1 Address: L'ont 2 r Company: City: r-no- TQC eL State: t-- Address: Zip Code: N�1�2— Fax: City: State: Phone No. - 7 .� Ohlo Zip Code: Fax: Phone No E-Mail E-Mail: Fill in fee simple Tit Holder on next page ( if different from the Owner listed above) State or ounty 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. SUPPLEMENTAL CONSTRUCTI:ON�LIEN LAWS INFORIVIA�TION, r DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name' Florida Engineering Name: Address:4161 Tamiami Trail Suite 101 Address: City: PortCharlotee, State: FI City: State: Zip:33952 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 1 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,ignder or an attgMey, before commencing work or recording our Notice of Commencement. C=ZD Signature of Owner/ Lessee/Contractor as Agent for Owner Sig ature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF SJ . (r,, e i e.. COUNTY OF St. I_uc.i C_ Sw7to (or affirmed) and subscribed before me of Swop to (or affirmed) and subscribed before me of ✓ Physical Presence or Online Notarization Physical Presence or Online Notarization this I dayof C4e v 2020 b Y this )A- day of © 2020 b Y Y Wi II i awe l i 1 1 b bet* s4o~ Name of person making staternefit. Name of person making statement. / / Personally Known OR Produced Identification/ Personally Known OR Produced Identification Type of Identification Type of Identification Produced Qc. "u-%oL•S,e- Produced L (Signature of (Signature of Notary Public- State o orida ) ALEXA KRATT Commission +�. `Fi1 Notary Public State,2f lodda ion # GG p19 Commission N ►*Y �" •. ALEXA KRAT Seal State 401a M Comm. Expires May 4, 2024 •'` y ' Notary ublic - of �! commission # GG 984139 .......... n F o ed hr u NationalNotaryAsin. REVIEWS FRONT ZONING SUPERVISOR PLANS VIE GROVE REVIEW COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.5/6/20 5��'tv S:UPPLEMENT�AL CONSTR:UCTI,®N ,LI�N"'j" NeFORM 4TION ��� P§i.t 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 witlilefte,r,or anattoxne-v before commencing work or recording vour Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF M41IZ7 1 COUNTY OF Swoppto (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of V Physical Pres ace or Online Notarization this l! -Aday of 314ad,E 2021 by Physical Presence or Online Notarization this day of 2020 by 'V4.kUu.i4Y11� ,t LJ_� Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Ty f Identification P oduced J Type of Identification Produced (S'gnatur of Notaryubliof Florida) (Signature of Notary Public- State of Florida ) ,Sft®ate Commission NoA44 09 d 0 ` IL •.. DENICE BOU :°; ' M. Notary Public Sta ` Commission N H 11mmis n No. (Seal) a of Florida 098492 REVIEWS FRONT .,,orr►;.,° ZON G My Comm. xpu ° ' ay , IN ` VEGETATION SEA TURTLE MANGROVE COUNTER REV I IEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 5/6/20