HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
Date: Z ZD Z U Permit Number: �C511J a� 11
0 T
RECEIVED
O
°.` ;° . . `^` Building Permit Application NOV 05 2020
Planning and Development Services Permlttin
9 artment
Building and Code Regulation Division Commercial Residential st. �uc'
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: e \ q�
e.a zNhda�S frvs � s .;yaK3'4r r r- cr 7a" J �1gtwua
IFP
POSED�I�MPRj , ' EITL® .4 � 3. �1. � �,. '
Address: Z 4,
Property Tax ID#: 2s " 0 _O ' /b —0 — Lot No.
�
Site Plan Name:
Block No.
Project Name:
ORION- y ,� `
Yawe.�e' '."�4-'� OF�"'�- u :.;yro�., .�•e.
X �� Or
,� c�
11-17
r h ' U( cam. r pj—
New Electrical Meter Second Electrical Meter
GONSTRUt INE® � �CTOC . .r5 SM TI'®NvY ?
VZ
r
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% 46 cy),-ny, 1/ Sq. Ft. of First Floor:
Cost of Construction: $ 37g Utilities: —Sewer —Septic Building Height:
"Cj
OV1/NER LESS'E f x, r; t `j4 CO1 ACTOR
Name Name:
Address: 0,? �f Company.
City: State:( / "Address:
Zip Code: W20 Fax: / City: State:
Phone No. o^ b 7 Zip Code: Fax:
E-Mail: l 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.
U�P EMS, R, C N TRU1 t®.:ALt° N�lA1IV IN R� YT �`N,4 _ ,.
_ . „� -
DESIGNER/ENGINEER: Not Applicable MORTGAGT COMPANY: �_ Not Applicable
Name: Name: �G►�r'c, LG /y
Address: Address: .2 r-✓
City: State: City: tatp,�_
Phone p: -- Phone: 95T -7�
Zip: Zi
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER permit to do the work and installation as indicated.
/ to obtain a
CONTRACTOR AFFIDVIT.Application is hereby made
has commenced prior to the issuance of a permit.
I certify that no work or installation
St. Lucie Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
structure. Pleaslecconsult withyoiurHlomeOwnners Association ion
drreview your deed for any restrict that
which may a prohibit such
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 Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF -S COUNTY OF
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed) and subscribed before me of
Physical Presencg or Online Notarization Physical Presence or Online Notarization
this 5 day of �� 2020 by this day of 2020 by
J\N114}\�\e, �
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 3 L Produced
t:
(Signature of Notary blic-State of Florida �li(Signature of Notar Public-State of Florida)
NS t
Y
_ Mp,�t1E Gi (Seal)
ipt3#
Commission No. (A" d �,. � M►� b�16,2020
ommission No.
' ;« P1RES.0 public UndeH+t11s
'a-
I'Aj•.••VO�•�
REVIEWS FRONT
SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.
I