HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUSS BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � ,��✓ Permit Number:
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)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION: ;} c
/ _
Address: 01/'� Oc� � �,o. F^. �`l y/ ��/r fc'/� tt�i
%J J 7r'/
Property Tax ID#: 7 / / 0,2 0`/ C F J ��� Lot No.
Site Plan Name: (i 11-61el V L1217' Block No.
Project Name: L' r
DETAILED DESCRIPTION OF WORK: / t
Cm an air-
--Q u 01
New Electrical Meter r' 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 _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: 6 Sq. Ft. of First Floor: 3G
Cost of Construction: $ j��C c;U Utilities: Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Cur ale 'u 1/1 d Name: �4401
�
Address: '! f Company: J n `"f . J J` -1"�< • � -
City: /�^ �i Stater Address: Gt0/ I- ��-�tr ��-
Zip Code: I T d i/2 Fax: City:� i?��/� J•ems"G>� State: e�'.
Phone No. -2 y� - 941- /3 7 7 Zip Code: 7 Fax: 7/_L��-�1
E-Mail: Phone No 77') -.W,() 3 n`�
Fill in fee simple Title Holder on next page(if different E-Mail t7 �a M S✓r>'���i n e- 0) "!Lq G 2
from the Owner listed above) State or County License
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.
SUPPLEME L CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINE _Not Applicable MORTGAGE COMPANY: _N plicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applica ONDING COMPANY: Not Applicable
Name: Na
Address: Address:
City: City:
Zip: one: Zip: Phon .
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 Jobsijt2 before the first inspection. If you intend to obtain fi ancing, consult
with lender or_a_rtmttorney befREt2L02t2encing work or recording you tice of Co m ement.
Signat f Owner/Lessee/Contractor as Agent for Owner Signatu of Contractort-c-fr.e Holder
STATE OF FLORI[ A STATE OF FLORID# t")
COUNTY OF l,� ,OI Y�n COUNTY OF
Sworn (or affirmed)and subscribed before me of Swor�,,to(or affirmed)and subscribed before me of
Ph�y'�sical Pre nc or Online Notarization VPhysical Pres nce r Online Notarization
this n�day of f5CTV 2020 by this,2j�day of Y 2020 by
))S&c �-)l��I i "l 11jr,2 L�'-f)i4)
Name of person making statement. / Name of person making statement.
Personally Known OR Produced Identification y Personally Known OR Produ
Type of Iden fication Type of Id e ifil c i YP"o, ^KATH RYN D ATO
Produced ��� Produced Notary Public-State f Florid
Commission # V 905979
� n j�, , �,e� My Commissi n xpires
V„ll� Se tember 1 023
(Signs re of N y Public-Sta �,,ora a KATHRYN D'AM�li da re f Nota blic-State of'fP6�'�
7 n ``O`ppVPUAC% Notary Public-State f o f a
Commission No. wl1 _* I�ommission # GG 05979 i ion No.G69D`P_111 (Seal)
My Commission x5R@
%E9,;;;° September 14, 023
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6/20