HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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:
PROPOSEDIIVIPeR®USEIVIENT_LO`GATIQN
Address
Property Tax ID#: t 2J �2.: 1— o'-�'t �� - Lot No.
Site Plan Name: I Block No.
Project Name: ODLOI v-)O\
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c_— 4h n o
k -fi q 5C ' l`CS C�t f e cT -r-D 60D .
New Electrical Meter Second Electrical Meter '
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CO VfS fRU TIONi�NFO,RM,.TION ,-
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 t Z • Pitch
Total Sq. Ft of Construction: �`�� Sq. Ft. of First Floor:
Cost of Construction:$ -J, Utilities: _Sewer _Septic Building Height:
t'^ 4 f`=n -`` °- ,✓t a +. .yj9 3.s c §x a E 6 ' y N"Vn12
ODUN,ER/1ESSE�E � C®NTRACTORx £tr
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Name Name:
Address: L[g0(;5" C cx(A( df/IKQ� _ Company: ya
City ,3-t-?LerQ,r State Addr ss:`z� l `D G�i�
Zip Code::3 4�S Fax: City��51fitat ' Stater
Phone No.
Zip Code:�U 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 y
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.
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S`' iPPaLE , ltNl'ALS ONS Nil; N LIEF, Wg Nt FQ`RMA�TI®N
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: 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 Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room . [0 ,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to ano �ir
residential use
WARNING TO OWNER:Your failure t Recce�l a Notice of Commencement may r It in twice for
improvements to your pro A otice of Commencement must b cord the public records of St.
Lucie Count os on th�j6bslte before the first inspection. I ou i nd to obt ' Inancing,consult
with le r or a orne 'b ore commencingwork or recordin our, otice o encement.
i —
ture of Owner/[essee&xzCfvcr6ras Agent for Owner ture of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF COUNTY OF Sl.. Q
worn to(or affirmed)and subscribed before me of S orn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this day of kT,)O `i�n 2�0^20 by this`'50 day
of �h(�►�1� 2020 by
� �v� r
Name of person making statement. Name of person making statement.
Personally Known ) OR Produced Identification Personally Known , OR Produced Identification
Type of Identi icat'on` Type of I en ification
Produced I (1�X Produc luftC"Q--
44
(Signature of Nota u IP- (Si ature of Notary u�B'c .t4 ilk Huic a
rot Notary Public State of Florida
oa My Commission GG 098831
Commission No. Q Oom1-1 ro so 098831 COmmISSlOtI NO. ov�op Expires.0.4/2�fi ���
orflo� Expires04/27/2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
1=5/6/20