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HomeMy WebLinkAboutBuilding permit app (2) CO, x,. 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. 'Inconsideration 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 woWor recording our Notice of Commencement. Signature o ner/L /Contractor as Age t f r Owner Signature of Contractor/License Holder STATE OF FLORIDA �)�,' STATE OF FLORIDA COUNTY OF COUNTY OF Swor to(or affirmed)and subscribed before me of Sworn to(or affirmed) and subscribed before me of 1 Physical Presesnc�e or Online Notarization Physical Presence or Online Notarization this 2020 by this day of 12020 by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificatiafl % Type of Identification Produced Produced (Signature of Notary ubli on i� EN S. N I ELS E '( gnature of Notary Public-State of Florida) State of Florida-Notary Put lic Commission No. •= Qg@�pission # GG 2074 4C mission No. (Seal) e My Commission Expire "'OF June 12, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r _ 0 Date: bf()V-.d4 - �D2_0 Permit Number: I ,�, ccic ec" `" L - RECEIVED 09 d��D� �PC� NOV 21010 Building Permit Application P p�itting p� D0 a,tment Planning and Development Services St.Lucle'Count/ f Building and Code Regulation Division Commercial Residential V 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR:51A JOTT L-I-A /MP'Li'iJbq Z POL9 >aa '�Y'd�v ®POSEDMP�®UE,NTLOCAiTfO _ _ _ tea.,. � Address: 22-W N 42,NO ST 1'rORI EiEZIPE fi-�L 349412 Property Tax ID#: I14 3 I- O D f 000Z- Wo/0 Lot No.� Site Plan Name: A40R."00 14-E 10418 Block N Project Name: ®ET��'D - .�NST-^LA-A 0 F W O QbE lt-1 Ti WA N FEN Sdv CAA&L71 KI C o N F Si IN(a UP G Wrl; 'L s 7Do UB IE Oram New Electrical Meter Second Electrical Meter I'M*, �1_�Y1 ,-F��i�'eY+"ltSr�e��t`F.�a wrQlF'.�' --E=��.i r .kx� amom", ,.:?.=T�'R•IIeT8i7s':t�.C_�a,�,��'�'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: S1 Sq. Ft. of First Floor: Cost of Construction: $ Z+ 4©®• •�v Utilities: —Sewer _Septic Building Height: '` u£ 'e� qa' ate: f ,r„.°'s`lY zy r 'w.icy om•;`'1,t"ti} L'�-'T..-;fy; -'- i l- OWNER/-t125SS'EL; - Name IFLI-( p4ELiAJlh WLLAO 'Name: - Address:Z7-t 6�1 iN 4Zi1 . G* Company: city:FORT PieizPz State:Jam• Address,: Zip Code: -34 614lo Fax: City:" - State: Phone No.-4'-72- ZZ4 -I C117ty Zip Code: Fax: E-Mail: V-ja•or 1 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.