HomeMy WebLinkAboutBuilding Permit application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Z3• �-(� Permit Number:—-U) )• ID n3
RECEIVED
4.
° Building Permit Application Nov 3 2020
Planning and Development Services per It opartn7 •
Lucie Coun�4
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: \�0L
Property Tax ID#: JA\-3--JYL- Mbk- Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
LLM
New Electrical Meter Second Electrical Meter
te e_ uil
CONSTRUCTION INFORMATION: '��-e-
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: $ 00. Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name:
Address: \��Q� � v'- uN�oy1 q--o CA Company: -MCA.. �crne� S
City: Address: 2-kcm
Zip Code: Fax: City: Qb� , So.� �,�Q_ '3" t te: J�a-
Phone No. 3l q3- Zip Code: %,A ckS3 Fax: /
E-Mail: Phone No by L- n&a-? 1q�
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _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.
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 Zan attorney before commencing work or recording our Notice of Commencement.
Signature of Owner Less a/Contractor a nt for Owner Signature of Contractor/License Holder
STATE OF FLORIDA - STATE OF FLORIDA
COUNTY OF 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 day of 0)rV . .2020 by , this day of .2020 by
nl,ae'4 :InW ma's .
Name of pers n making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of ldentifica ion Type of Identification
Produced Produced
(Signature of Notary P ic-State of Florida) s (Signature of Notary Public-State of Florida)
{ 7B. HREY
Commission No. :eCommission No. SealG300817
E 2023
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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