HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ` 0~ Qk- `oZD Permit Number:
217o LUM ao o .0 5 53
0
Building Permit Application
Planning and Development Services O C T 2020
Building and Code Regulation Division Commercial Resid r�VaLl . _
2300 Virginia Avenue,Fort Pierce FL 34982 u,e eounty, Re Ing
Phone:(772) 462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: a
PRQPOSED, IMFROVEIVIENT;LOCATION: 44
_.
Address: ao Si Lu c i -e R 10 c 2 Ft P i k at :e. A(9
Property Tax ID#: C. Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION h:S T:l .pa " �.' . .-, � '. td y . 4 t ' M"r•f 4 F 'F
.
New Electrical Meter Second Electrical Meter
C0NSTRUCTION'1NF0.RMATION , ,
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:$ J1r n() Utilities: —Sewer _Septic Building Height:
'OWNER/LESSEErs ``sr' ... =� ..
CONTRACTOR
Name Name:
Add ressac S'*u"Ci e Akurn Company:
City: ��} 0%-� 2C "e State: t Address:
Zip Code Fax: City: State:
Phone No.' n �- 3501 - ��(�� Zip Code: Fax:
E-Mail: Phone No
Fill in fee simple Title Holder on next page (if different E-Mail
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.
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.
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.
ture of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLTRIDA STATE OF FLORIDA
COUNTY OF -V COUNTY OF
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed) and subscribed before me of
Physical Presenc or Online Notarization Physical Presence or Online Notarization
this�.�f day of CS�� 2020 by this day of 2020 by
V'�c 1L'\ C a-y"Ib S
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- L Produced
(Signature of Nota4 Pu iC :of FIoiR MARIE GIVENS (Signature of Notary Public-State of Florida)
MY COMMISSION#GO 022023
EXP ES- ber 18,2020
Commission No( 6 ` ga lPublkUndetwrltsn Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED 7- _71
DATE
COMPLETED
ev.