HomeMy WebLinkAboutBuilding Permit Application INFO.MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / ,A(—o
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APPLICABLE IN . �� `�1 Permit Number: o�� RECEIVED
Dater
j1 n 11 0 g 0 7 ,2020
LSI�S(r,ll Permitting Department
�: Application St. Lucie County
Q .a-o.. i ;..D. o :. Building Permit
Planning and Development Services , Residential X
Building and Code Regulation Division Commercial -
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: MULEHIDE RLO\O�F
PROPOSED IMPROVEMENT LOCATION:
Address: 8604 PENSACOLA RD. FORT PIERCE, FL Lot No.--
Property Tax ID#: 1301-609-0023-000-3 Block No.
Site Plan Name: LAKEWOOD PARK
Project Name:
OETAILED DESCRIPTION OF WORK:
IN G ROOF AND REPLACE WITH MULEHIDE ROOF
REMOVE EXIST -
New Electrical Meter__
Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply: Pond
Gas Tank —Gas Piping —Shutters Windows%Doors -
Mechanical — Pitch,
Sprinklers Generator _Roof
_Electric —Plumbing _ P —
��� �- Sq. Ft. of First Floor:
Total Sq.-Ft of Construction: ` .
Cost of Construction_: $
Building Height:
Utilities: —Sewer —Septic
CONTRACTOR:
OWNERAESSEE: .
t l Name:
Name —
' � aCh. Company,. -- - .
13
Address: .'.
i State: Address*' y�
City: / f — r
Zip Cod e.'- ; Fax:
City: Stater
Zip Code Fax:
Phone No.
Phone No
E-Mail: �J
Fill in fee simple Title Holder on next page if different E-Mail `�
from the Owner listed above)
State or County License ''
'ce of Commencement is required.
ORDE D Noti
f construction is 2500 or more,a REC is required.
value o ent q
If va encem
Notice of Comm
If value of HAVC is$7,500 or more,a RECORD
ED
D N 0
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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.
Inconsideration 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 o wner/Lessee/Con actor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA 1
COUNTY OF COUNTY OF
Swo n to(or affirmed)and subscribed before me of Swoyn to(or affirmed)a d subscribed before me of
P ysical Pre s ce r Online Notarization ✓ Physical Pres Online Notarization
this day of p 2020 by this day of 2020 by
�y' T
Name of person m kin statement. Name of person m kings tement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
'(Signature - N (Signs
S yP(je� � � KARE.N S. NIELSEN
��YState of Florida-Notary Public =a°�P e�;State of Florida-Notary P !�
Commissi �d Co:u�iission 4 GG(S�1�84 Comm 5 r rr _ __ GG 2074 4
My Commission Expires
June 12, 2022 ', oFF�o�; 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 20
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