HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r1 )
Date: a )' o�� Permit Number: V "
RECEIVED
Lira L�Lo'cuC OCT 2 2020
,.A Permitting Department Building Permit Application St. Lucie County
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,IMPROVEM'ENT LOCATION
Address: 1-7 2; P SGI C:ICo Ce� rc)d �y1V� �0�r+ Sk• LU'c,ie , �L
Property Tax ID#: 3 - SO i - CO2S —ono — Lf Lot No. 2S
Site Plan Name: ,^, Block No.
Project Name: 3ccdd <c b ron`C. axs 1 do nC-e.
DETAILED:D:ESCRIPTI ON-Of WO.RK:. .
e— o o 41 le Iz. P A)01
New Electrical Meter 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: d sc D Sq. Ft. of First Floor:
Cost of Construction:$ -5-0,00c) 00 Utilities: —Sewer _Septic Building Height:
01NNER/LESSEE -. ;CONTRACTOR`
Name i L i k=d Name: c7
Address: P6 &>e Dc](a�� Company: i��c(. o Sv1Lsfi��'S
City: (9dJh r%• IJCfi.- �ftr�S State: r`'L Address:
Zip Code: D Fax: City:f4 � State:iF-L,
Phone No. -.s (-36 3 Zip Code: 3 3`A 4A Fax:
E-Mail: Phone No 61-3o3- �(o
Fill in fee simple Title Holder on next page(if different E-Mail a OY\A 0 r'`
from the Owner listed above) State or County License Sfiuo(' 4
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.
RSUPPLEMENTALCQNST
DESIGNER ENGINEER: U_CT.LOoNf Applicable
cLaAbWle INF,OMROMRTAGTIOENCOMPANY:
M
PANY Not Applicable
licable
— .
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _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 mayapply.
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.
SigNature of Owner/Lessee/Contractor as Agent for Owner =SFLORIDA
Contra r/Lice se Holder
STATE OF FLORIDA
COUNTYOF Pall(n BP061 COUNTYOF Paln-1 erack
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
`-physical Presence or Online Notarization �ysical Presence or Online Notarization
this 23 day of 2020 by this 23_day of OC fUbe/ 2020 by
j-r� ag ( Lock'ujocc� 3Qlnn 1GuCV�lc✓
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
P uc Prod
IN U
( i ature of Notary Public- 1 ary Public-State o . to ture of No u aF- t�iLeg* WIND
COM k GG 90 1 ;��Pw °�A��.�
Co ,o Notary Public State of Florida
-' - .2 ^= 909176
Commission Ex ires commissio
Commission No. '.�� o�„o°�(Selly August 29, 202 Com fission No. !�r '`` y Comms s Expires
` i ` August 29, 2023
II
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW. REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.5/6/20