HomeMy WebLinkAboutBuilding permit app All APPLICABLE,INFO MUST BE CO ETED FOR APPLICATION TO-K ACCEPTED ` /�,n
Date: ; '.�2 Q Permit.Number: C Q I f l J l A l
_ RECEIVED
' NOV o 2 2020
,4 •+ y r ..:aye •
Building Permit Application Pe�Slk};U9,°��ment
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772f 462-1578
PERMIT APPLICATION 'FOR: ��JJ
.t1ti 3na
Address:A 0 S'7 01-f/P L c7"T / R( n�t?9 dL._'edEf IK 9`lfA�a,
Property Tax ID#: J !JJ 14 01 J-73-000 i _ Lot No. /
Site Plan Name: G✓l�f S�Ly1�1' C , �� �� C Z?s Ole, Block No.
Project Name: rgoov l Poge-1-1
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1�,qz_ re�,e 1 0_2�z j�(3 mi �0
New electrical Meter Second Electrical,Meter C
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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.:. 010 Utilities: Sewer _Septic Building.H'e!ght:
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Name �i-T� � � �: • .{ .� �l/d.� Name• -
Address:AU /,�(dam/` /�L1.��, Company:
City: State 25� Address:
Zip-Code: `f q 40 Fax: City: State:
Phone N'o.o . � Gj(�' y���.- 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 hoiderto build`the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or an&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 ComMericement must be`recorded m'the public records of St.
Lucie County and posted on the jobske 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 L STATE OF FLORIDA
COUNTY-Of 1t� COUNTY OF-.-
SW n to(or affirmed)and subscribed before me of Sworn to(or affirmed)arid,subscribed before me of
✓✓ Physical Presencle or Online Not
rization Physical Presence or Online Notarization
this a day of 1�- 2QZQ by this day of ,2C_ by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identificatias Type of Identification.
Produced Produced
(Signature of Notary Public- taXBF,loricKREN S. NIELSE ( gnature of Notary Public-State of Florida)
State of Florida-Notary Pul lic
=* *= m ission # GG 2074 4
Commission No. '-"� °P' t�,�'ommission Expire mmission No. (Seal)
June 12, 2022
REVIEWS FRONT ZONING SUPERVISOR PLANS' VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE "
RECEIVED
DATE
COMPLETED
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