HomeMy WebLinkAboutBuilding Permit Applicationi
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1-015--bZ) Permit Number: ,.(�]) \lam 10%
91ro ���Q�;. RECEIVED
O
" ° � f Building p Permit Application OCT* 0 5 2020
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permitting Departm t
Commercial Resident &Lucie Cou .
PERMIT APPLICATION FOR:& ) M; )d;
Address: 15-ZI2 PlNe7_9616 eaCdQ', /ti
Property Tax ID #:vim �� - �� ��' ' 7 . Lot No.
Site Plan Name: Block No.
Project Name:
3s' X 60% CbNcAz-r6 P,*D wiru ei 30'X 90' _ kLAia/l
New Electrical Meter
Second Electrical Meter
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $�,
Generator
_ Windows/Doors _ Pond
Sq. Ft. of First Floor:
Roof Pitch
Utilities: _Sewer _Septic Building Height: /y'
Ccz. ,2T2 "-'Ss4: 'ht- V'v-,f'*y+{� A�dsC t`k e,4`S�.w3 °<.'pp'f" a+y, e4 Y*u.'X,i§�'l `£i'k^ ' `,t "wr`t j5 q' +
j4?S YA # 3. •r y��ka`x �.K ¢Qy 4Lffg?' .r+' S.S-� y'ak.+-,'T 'G .a {�1.`.v{ k'�`^�b % �Y yr{
4,�.
Name
Name:
Address: SL/z- 67-90 -0r-
City: t-%- D�:_Cc: State: Fz-
Zip Code: 30792- Fax:
Phone No. 77.1- - 2/6 - 82. & /
Company:
Address:
City: State:
Zip Code: Fax:
Phone No
E-Mail: Rask
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License
If value of construction is 2500 or more, a RECVKutU Notice oT Commencement is requireu.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
*0.
AL CONST°RU� °T I 0XNLIEN4LAW�IN
U+�!
fO R`<I�IIIA�TFhI+O` N "��T^y�ti , t
'��,n� ��rx.'�'. z �'
�.•�Y�a_ �,-•r...?
.PPLEMENT
a
°xza�',z�.rn`�_
4�..L�i,
e�t, ..L.,f�.:4 *.:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address: e1 Eizo O/L Sr& 1 s
Address
City: A4gL±1t&1-77' State: A-
City: State:
Zip: (30D3- Phone 9o0-37,/• Y6VX
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
with lender or
Signature
rnev before commencing worK or reLururng yUU1 IMULrLU U1
r as Agent for Owner
STATE OF FLORIDA
COUNTY OF— A F
SwW to (or affirmed) and subscribed before me of
Physical Pres nce or Online Notarization
this day of 2020 by
UWIT-s. &)_-,4<.V
Name of person making statement.
Personally K own OR Produced Identification
Type of Iden rcatic�r j,t _ n . ,
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of .2020 by
Name of person making statement.
Personally Known
Type of Identification
Produced
OR Produced Identification
(Signature of - ary u lic- e�p on a UDRE HUMP RI�Y (S nature of Notary Public- State of Florida )
MY COMMISSION # GG 00 17
Commission No. :o ($e2gkPIRES: March 6, 2023 Co mission No. (Seal)
'a Id i ", Bonded 7hru Notary Public Undenv r ers
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6/20