HomeMy WebLinkAboutBuilding Permits All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
0.5-4 If
0
° - Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772) 462-1553 Fax: (772) 462-1 575
PERMIT APPLICATION FOR:
PRQPOSED: IMPROVER/IENTLOTIO,N
Address: 3o2U —
Property Tax ID#: �O Sb Z (� I gl Q ( � Lot _
Site Plan Name: Block
Project Name:
..DE',SCRIPTI °�N 0F=.WORK
DETAILED. '-
__
11-V
New Electrical Meter Second Electrical Meter
:CONSTRUCTfON INFORMATION A !
Additional work to be performed under this permit—check all that apply:
X_fvlechanical _Gas Tank _ Gas Piping _Shutters _Windows/Doors ^ Pond
_ Electric _ Plumbing __Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: _ Sq. Ft. of First Floor:
d
Cost of Construction: $ 30 DI) __. Utilities: —Sewer —Septic Building Height:
01NNER/LESSEE`• CONTRACTO.R :`�:
Name L 7r—k)_Q ,5D/-N )_ _— Name:
Address: O Q -- Company:
City:pi7P_r•P_E S' te:_ Address: 5!�/��,i✓��✓Gfi �r l- — —
Zip Code: 3 Vf VS Fax:------ --- City:_ SZ—
Sta;
Phone No.7�� o��,S-�& &J Zip Code: 3 y 1 5�� Fax: /
E-Mail: Phone No ([j
Fill in fee simple Title Holder on next page ( if different E-Mail/?
from the Owner listed above) State or County I icens L'—"/Q—'-
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.
I
AL CONSTRUCTION UE'N LAW INFORfVIATION ,
. :,:•�:a:.Wtii:i'.- _....r•
DESIGNER/ENGINEER: — Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name;
Address: Address:—
City:
ddress: _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
with lender or an attorney before-commencing work or recording our Notice of Commencement.
ignature drdwne6 Lessee/Contra for as Agent for Owner Signature o ontractor/License Holder
STATE OF FLORIDA STA1 E OF FLORIDA
COUNTY OF24 jA k.e– COUNTY OF fj47 L bib rr`t
Sworn1,9r.kw affirmed)and subscribed before me of Swor (or affirmed)and subscribed before me of
_ ysical Presence or Online Notarization Physical Presence or Online Notarization
thi:, day of (�Z �' 2020 by this-It-Vay of QLe' , 2020 by
I
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification ! Personally Known OR Produced Identifica'
Type of Identificati n Type of Identification
Produced (_ , 1i roduced %f
f Not ry Public-State o� to ida ) �'".,„„"�� (Signa o Notary Nota—'Public-State o
(Signature of Flor °`) 3 m
�a 2 coo
Commission No. (Seal) 3®m ommission No._ _ _ (Seal) 3:'—'X
®030D s26!IM
DD
a a.
0 oz—
REVIEWS FRONT ZONING SU 50 PLANS VEGETATION SEA TURTLE o c
COUNTER REVIEW R o_ EVIEW REVIEW REVIEW �Ep
DATE
RECEIVED
DATE v a
COMPLETED
Te—v 757M-9—
— --1 - — .— ----