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HomeMy WebLinkAboutBuilding permit app COO All APPLI BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / Date: �� Z�iJ� Permit Number: r"LICIF CEUP.- Pur L4 ° "` ` ; Building Permit Application Planning and Development Services 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: -PRO OSED,IMPRQVEMENT LOCATION m,� - Address: 1 c13Co Property Tax ID#: La 1 - (:0Q - ry)l O !000 -Co Lot No. Site Plan Name: Block No. Project Name: i DETAILED DESCR"IPTION CiF1NORK �' _ - t��` New Electrical Meter Second Electrical Meter CO-N5.TR,UCTiC►NuINFORl1/IATION '` 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 I Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $&I W Utilities: —Sewer —Septic Building Height: I OWNER/LESS,EE CONTRACTOR k� . Name LVO' n Name: - w; Address:_ t 91 C a 014(o,-n irs, Pam- Company: `rru�. —'ernes_ City: Tj:)a 1?i P_-C_k_ State: Address: L4 R-(p S(J) Y'Y1Q f J o\e '17"-�f- Zip Code: 3�R� Fax: City:�S L Stater I Phone No. -)a - Cr 79 - 4131 -2 Zip Code: Qi Fax: _ E-Mail: Phone No--)'? -(J('7 - d(YT ) Fill in fee simple Title Holder on next page( if different E-Mail+rUf_`f'eMF­)Lz,C -,;I. from the Owner listed above) State or County License CAC_ MCI i 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. I I I SUpPCEMVI NTAL CQNSTR'UCTION LIEN LAIN INF©RMATI(JN DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable' Name: Name: Address: Address: City: State: City: State: 1 Zip: Phone Zip: Phone: I FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: I 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 De recorded in the public records of St. Lucie County an posted on the jobsite before the first inspection. I yo intend to obtain financing,lconsult with lender a att ne before commencingwork or recordi ur otce f Commencement. 0 I I Sig ture of Owner/L ee/Contractor as Agent for Owner Sign re Contractor/L ense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF St! I. cc lc COUNTY OF G/ Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of Phy 'cal Presence or Online Notarization Physical Presen or Online Notarization this a4ay of iy0✓ ,2020 by this day of 2020 by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification I Type of Identification / A v Type of Identification Produced Produced IE( h l (Signature of i -State lorida ) (Si nature of Notary Public-State of Florida ) ELLEN VA CCommission 55. StatejdaN44� o �v SC omm Seal) - o1y r7 c c� Commission tateF HN# GG 2700 01. orda-rotary publiMyCommissi 0 o er 22, 2022 %,OFFI 007g ,,,,,,. y Commissi REVIEWS FRONTII ERVISOR P 22 ` �ri�R E MANGROVE COUNTER REVIEW REVIEW REVIEW REVIE - REVIEW DATE RECEIVED DATE COMPLETED j Rev. 0 I