HomeMy WebLinkAboutBuilding permit app All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r �j
Date: ... Permit.Number: 0 �
Ut_ L
C4.,TR;- ryw Building Permit Application
Planning and Development Services
Budding and Code Regujfation:Division Commercial Residential lf''
230.0 Virginia Avenue, Fart pierce FL 34982'
Phone:(772).4.62-1553 Fax:,(772)462-1578.
PERMIT APPLICATION FOR:
14,q aan t ` 'z:rl
P!ROPO3 ItD [M ;RO EMIrNT LOCATION.' .
Address: 'f Q7"Zu o t'CYl Q e a V
Property Tax ID 4: Pq:rce l & �30ct,..- l+1_09 iQl 60,--_ � q tot No.
Site Plan Name: Block:Nb.
Project Name
I
DETAILED I}ESCRFFTiON QF WORK:
r 1a:4 rjrj-i -eri Ova cz r' `.C i Q i i%i -'h n 6 t"e-5
New Electrical Meter - Second Electrical Meter
I
C'bN T.RUCT dN INFQE�Il1iATION:
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: J3 1 5F' 0,46'4"C Sq.Ft. of Firsf Floor:,
. LSO R!!''
Cost of Construction:$ S Utilities: —Sewer _Septic Building Height: I
l
bw, , IER/LES$EE ; .C®NTRACTOR
Name.. LO'coa I H'ta rn i I tc►1 Name: dWWiE P JR(AIQ)
Address: 1 U 2 70 0-r^a►jq -e. V Company:
City: .
Ci }�� 1 c r^:C-c State: l 14 � .Address
Zip Code:5�f q Fax. City: State: i I
Phone No. 7 2. Z�i`i — �1; —00 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$1,500 or more,a RECORDED Notice of Commencement is required..
.�i:1�€�l,E,tlll�f�,�'i!�L
DESIGNER/ENGINEER. Not Applicable i MORTGAGE COMPANY: _Not Applicable
I Name: ± Name:
I Address; = Address:
1. City: State; City: State:
Zip:, Phone Zip: Phone: .
FEE SIMPLE TITLE HOLDER: _Not Applicable f BONDING COMPANY: _Not.Applicable
Name: Name:
Address: Address:
City. Cit
y i
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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,byinvs 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'buil ding.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.
I Signature of Own�rj Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLO A STATE.OF FLORIDA
IRI
j COUNTY OF IJ-1. c1, � COUNTY OF
Sworn to,.(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this ` fay of 2020 by this day of 2020 by
Name of person m ing s atement. Name of person making statement.
Personally Known V OR Produced Identification Personally Known OR Produced Identification
j Type of Identification Type of Identification
Produced Produced
Si net Notary Public-State of 0, µEL,SSAA*14EELER
{ g re of y i+oca�Pubils•Swe of No rgnature of Notary Public-State of Florida)
a� e? Camrnissias GG 305306
my Commission No. 0✓ y �a{1dedthr upoiaicralNres 24,A5 in.2 t3 mmlSSlOn No. (Seal)
s i�sl!hrrn ga Na:crai N Kary
REVIEWS s FRONT I ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE I MANGROVE
COUNTER i REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW I
DATE
RECEIVED j I
DATE
COMPLETED
ev.