HomeMy WebLinkAboutBuilding permit app All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 (` 0 3(0 Permit Number:
99, ° ° p 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:
Address: 511�0 C[.�b�s�,atC I_,oa� _ �or�T _ L�rci AFL 634957
PropertyTaxlD#: 330!k'- Laos- 6B34 - 600 - 1 Lot No. 31
Site Plan Name: Block No. A
Project Name: o
DETAILED DESCRIPTION OF WORK;
S`Zr1'�1 wl�-��+C.M �lTT1�.l_ lZ�r9F SJSTi�If.� .
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 1P rz. Pitch
Total Sq. Ft of Construction:_ 3 9 go Sq. Ft. of First Floor:
Cost of Construction: $ !L Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name tlt:tn_ ! !AL:1nr<C_rrCW " Name: �Z�u,u� '►�.,►��Giz< 1 .ram_
Address: _ i;0 LLdT2ESSA1 X:. A6dr Company: t?,6ZKM r
City: :;>0P=- S-r. L_.rc.�.*< State: 'Ft- Address: jj� Rme (cs- /
Zip Code: -Ids-6:7 Fax: City: !-dwrz._Saotsa. State: FL
Phone No. .Q�rQ l 24 aV•-93-7 - Zip Code: � �(�7f Fax:
E-Mail: Phone No 2- Z - fu6_3nn
Fill in fee simple Title Holder on next page(if different E-Mail ;c,p ��-;�,n rzSddi-;,,.�, C_C5VV%-
from the Owner listed above) State or County License cG1
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.
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SUPPLEMENTAL.CONSTRUCTION LIEN LAW INFORMATION:'
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable,
Name: ame:
Address: Address:
City: S City: e:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLD _Not Applicable BONDING COMPA Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Z' 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.
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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. Ify u ntend to obtain financing, consult
wit lender or t ne before commencingwork or recordingu N tice of Commencement.
CWn V)11�11
Signatur er/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA ���
COUNTY OF WRY«./ COUNTY OF
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Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Peal Pre� c`e or Online Notarization
C--t)this (I- day of O1;s 2020 by this d y of /VW {,1L 2020 by
Name of person making statement. Name of person making statement.
Personally Know OR duced ntif' ti n Personally Known OR Produced Identification
Type of I tifi tion Type of Identification
Prod d Produce
,
(Signature of Notary PublidVStaTe of Florida ) (Signature of N tary Public-State of Florida)
Commission No. ANVIY1. NM44" tic State of Florida Commission No. I ��I (Seal)
.,Robert Alan Austin
MY ComMfseiole GG 098018
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REVIEWS FROM PLANS VEGETATION SEATURTLE MANGROVE
COUNTER, REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW,
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6/20
LUCILLE V.HANCHECK
Notary Public,State of Florida
utn if
My comm.expires Jan.25,2022