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HomeMy WebLinkAboutBuilding permit application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �( Date: Permit Number: O Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1S53 Faux: (772)462-1578 PERMIT APPLICATION FOR: FRQPOSED"IMPROVEMENT Address: 1 0 9 vE 'A'SIt'cam\ ..�5 �, W Property Tax ID#: Uo Lot No. Site Plan Name: Block No. Project Name: 5 C,2.C,` DETA�ILEDDESCRIPTION OF WORK 4 4-L ri C R .i C�e \GN G2 6_3A�r o ` C'(Sn Z-(`,4, Tom- �C`��C n A-N Lx�j New Electrical Meter Second,Electrical Meter 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:$ cZ300 Utilities: _Sewer _Septic Building Height: 'OWNER/LESSEE CONCTOR TRA Name et` dlyxao Name: U. Address:- I f' 2�S Company: City: rN�,�r., arl` 0,c,-r4,rt\5 S Address: Zip Code: Fax: Phone No. 772- 515 SaUl Zip Code: Fax: E-Mail: Phone No 7 i72- Fill in fee simple Title Holder on next page (if different E-Maile��� from the Owner listed above) State or County License_,�_?)(_L�osci IY W If value of construction is 2soo 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. G �-- .c: n- .,�, -�--_. �,,.. y-._tyc.a. c .-r'7 !fS 4 t 'k. -..1.+:...r r��i _,Ltayr,r-�}4S y•. SUPPLEM;ENTAL`COIVSTRUCTION"L'IEN LA AT W,IiNFORM A. 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 an 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 mus be recorded in the public records of St. Lucie Cou ty and posted on the jobsite before the first inspection f you intend to obtain financing, consult with len er o me before commencingwork or recor, i our otce f Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORID%/ STATE OF FLORIDA COUNTY OF `�' COUNTY OF Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of Physical Preser},�ce or Online Notarization Physical Presence or Online Notarization this 10 day of v � 2020 by this Wday of © 2020 by Len CLqkfk) 0 AA Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced L,Dqq l' Produced �- (/V (Signature o o lry,?u lic-%iglI idG)H N (Signat - tPPY P 111 11/, State of Florida-Notary Public �SPPrv�Bo 7LLEN VAUGHN Commission # 0079 ;State Florida-Notary �Ielgj Commission Q - '���E OF FlOQO`' my mission x�ires Commi i9 oP, ,;GG 270079 '"�III11 October;3; , g9�8 %. OFF,, My Commission Expires �1n I I nF`` — , ot REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.