HomeMy WebLinkAboutBUILDING PERMIT APPLICATION - NEW CONSTRUCTION SFRAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: OC+o'oer 2C\, 2..020 Permit Number: ________
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Co m me rei a I -----Residential ----
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Ne.wCm~Oh" Sln~\e FaMi\,-/ ~6ide~
PROPOSED IMPROVEMENT LOCATION:
Address: ~7( .Ne..+He:s Bvd., J(!h~n Beac..h, FL.. ~q57
Property Tax 10 #: 450'2.-50\ -0757 -a:t> 2Lot No. 571
Site Plan Name: t\odSoY) Block No. ___
Project Name: dod:SC1r'"\ • Ne\A.J Re~iden-\ia.\ Lon!5truc.firo
I DETAILED DESCRIPTION OF WORK:
New Electrical Meter ____Second Electrical Meter______
[ CONSTRUCTION INFORMATION: ..J
Additional work to be performed under this permit check all that apply:
~echanical Gas Tank _ Gas Piping Shutters)< Windows/Doors Pond
~Electric ~Plumbing _ Sprinklers Generator X Roof Pitch
Total Sq. Ft of Construction: gets "5.£ Sq. Ft. of First Floor: _________
Cost of Construction: $ 2\S,cco.OC> Utilities: ~Sewer _ Septic Building Height: ____
OWNER/LESSEE: CONTRACTOR:
Name 6nerl L. !jod~ Name: Mar~.M t.tfr)'-:;
Address:.qs~ Cou-tn y p~\fail Company: ~l-~~ruc-nCY\,~.
City: MldWti~g State:ctl Address: 1:; .
Zip Code: 45342: Fax: City:~f3each State:£b.
Phone No. q~~-~~: Zip Code: 3t¥t5i Fax:
phone No n2-·22q~E-Mail: +-b:t~ ~ _11· t:.tJIY'\
Fill in fee simple Title Holder on next page ( if different E-Mail M1.cl("*~~~
from the Owner listed above) State or County License ___0_412.
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.
l
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
State: State:City: --City: -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 .
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 attorne before commencin work or recordin our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner·
STATE OF FLORIDA
COUNTY OF ? T ' \ \ JG ,,~
Sworn to (or affirmed) and subscribed before me of
X z.q sical Presence or Online Notarization
thi? day of OC:±V~. 2020 by
;5he.ri t±od?a~
Name of person making statement.
Personally Known X· OR Produced Identification __
Type of Identific~ . ' .
Produced--,,--,L___-.-___-f--I
Commission
S'«Sfn to (or affirmed) and subscribed before me of
..L Physical Presence or __Online Notarization
this __ day of , 2020 by
AACl(L Mat05
Name of person making statement .
Personally Known L OR Produced Identification ___
Type of Identification
·Produce r _______~-r---
Commissio
~.'~?:~~';u IC . ' ~':*l MY COMMISSION #GG 9M~OO
". ""O'W EXPIRES ' lanual¥ 18. M'4 al )
" '~f.r.:••" Bonded Thru Notary Pobllc U;'derwrno"
REVIEWS FRONT
COUNTER
ZQNING
REVIEW '
SUPERVISOR PLANS VEGETATION SEA TURTLE. MANGROVE
REVIEW REVIEW REVIEW ~EVIEW REVIEW
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