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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED °o���n Date: 11- D' ��' Permit Number: Zil /' v (0 /v` g4o n uQaE 5 2D o NOV 2 2 5 010 IFD tnt ` Building Permit Application Permitting Department Planning and Development Services St. Lucie County 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: A @ fa PROPOSED IMPROVEMENT LOCATION: Address: Property Tax ID k: •4 C5 1-1 J'!F7-o0 —� '"* d kc7 d Lot No. Site Plan Name: Block No. Project Name:A"farj- �1. - DETAILED DESCRIPTION OF WORK: L --m try Act sA-, ed�u—L eX • --New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additional work to be performed under this permit-check all that apply: —Mechanical =Gas Tank _Gas Piping _Shutters _Windo /Doors _ Pond Electric Plumbing _Sprinklers _Generato _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First aor: Cast of Construction:$ ©� Utilities: -Sewer _Septic Building Height: OWNE R/LESSEE: CONTRACTOR: Name _t oS �TCA1�lYas Stem Name: Address:�`Z L1.3 t _1k hm-_� Compan . City: L�?� zi State:_ Address: Zip Code: Fax: City: Stater — Phone No. Zip Code54�r��/ -4"-P+� � ax: E-Mail: Phone No ` L7. 2-i-7 Fill in fee simple Title Holder on next page(if different E-Mail S Q� from the Owner listed above) State or Coun ;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: S tte: 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 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 Flori '3 Building Codes and St. Lucie County Amendments. The following building permit applications are r-; •mpt from undergoing a full concurrency review: room additions, accessory structures,swimming pools,fences,w Ils, 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. Signat�fowner�essee/C�ontractbr s Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORID COUNTY OF_A. b3ue. COUNTY OF �,I J]Ct,�r. Swoon to(or affirmed)and subscribed before me of SwoL%t6(or affirmed)and subscribed before me of ✓ Ph sicaI Presenc or Online Notari 3tion ical Presence or Online Notarization this day of W , 2020 bt. this day of .2020 by Name 51 Oirsobmaking staftem nt. Name of persoA making gsstate nt. Personally Known r/ OR Produced Identification Personally Known " OR Produced Identification Type of Identif ation Type of Identification oduceci Produced I AA ' r (Sign lip im (Signature of otfvy,Ap is-k o SEN KAREN S. NIELSEN " �'' ;� e,Slate of Florida-Notary Public State of Florida-Notary P�µtpp��tt Commission - Commission a q§��484 Com _ ;—Eemmras*CmR..C�0 207,1$C4 `,�? ,y ommission Expires My Commission Expires '�St"°� June 12, 202E REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.