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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETE© FOR APPLICATION TO BE ACCEPTED Date Planning and Development Services Building and Code Regulation Division Permit Number: Building Permit Application 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fa)(: (172) 462-3578 PERMIT APPLICATION FOR: Commercial Residential PROPOSED IMPROVEMENT LOCATION: Address: -3d--�-6' FAH v Property Tax 1D #: � "� Ca C>ya -C O G �.dZ 4 t� e' - 4 W-t* f tea. _ Lot No. U �� 1 .. J� p Site Plan Name: f-A_ vntc� /� ✓/1 �,t;./)- �1vtJ5 e C ��Y� /�9 �_� G�.5�7� �t Block No. Project Name: 1 A411U'5 A- DETAILED DESCRIPTION OF WORK: C� �,•-���ta �. r t �J 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 _Numbing _Sprinklers _Generator i}too i`- Pitch Total Sq. Ft of Construction: 1`!L�'t Sq. Ft. of First Floor: Cost of Construction: $ _ �'` Utilities: —Sewer —Septic Building Height: OWNERf LESSEE: CONTRACTOR: Name Le t' Name: !TU' S '` �f, - -- _ .. Address: 2 -�c�' � M1 �1.11 ''- Z7WYc - .Company: 7-E G d } City: / r f'.r •cr State: _,� Zip Code: ��i 5)- Fax: �g Phone No. r� � �! E-Mail:-+,a-c) Address: City: _ed. .3 ( dc.r-tom StateJ� Zip code: 3Fax: Phone No Fill in fee simple Title Holder on next page ( if different from the Owner listed above) if value of construction is 2500 or more, a RECORDED Notice of Commencement if value of HAVC is $7,500 or more, a RECORDED Notice of Commencement E-Mail �'{ 0 �l State or County License _ee.�- is required. is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Name: _ Not Applicable MORTGAGE COMPANY: Name: /°Not Applicable Address: Address. City: Zip: Phone State: City: Zip: Phone: State: FEE SIMPLE TITLEHOLDER: Name: -"Not Applicable BONDING COMPANY: Name: _/Not Applicable Address: City: Zip: Phone: Address: city: 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 to obtain financing, consult With ipndpr nr an attnrnev hefore commencing work or recor your Notice o Commencement. Signature of Owner Le ee/Contractor as Agent for Owner nature of Contractor/License Holder STATE OF STATE OF FORIDA�q COUNTY OFORIDA c } Czpnor. Sworn.to (or affirmed) and subscribed before me of Saffirmed) and subscribed before me of Physical Presence or Online Notarizationl thisrL dayof � r 2020 by Presenc or ! Online Notarization this jday of �^ 2020 by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification "5 Type of Identificatio + tr Produced r i_ �C �2 t �C �� Produced {S" , ature of N tary ttbFic--State- leFibia- (Signature of Notary Public- State of Florida,),•�e ^ ++ MIGUEL NAPOLES .1L R[1CHA1 L AfcH G r1Y COP,,, � Commission No. : :_ �( I I cGot2039 (r � , 4f! � ,. Commission No. Seal: l COMMISS[U\ � EXPIRES ; _ ; f � \I'I€tCS: Jzuiiiher I i REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 5/6/20