HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: //'3O-ZO
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Planning and Development Services
Permit Number:
Building Permit Application
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: 7 D 41k 3 fYS-/
Property Tax ID #: /3/ Fo?/ - 0 e 0 - DAD '7 Lot No.
Site Plan Name: _Zrei,1AAW 4aZQ Block No.
Project Name:
I DETAILED DESCRIPTION OF WORK:
Abe -.e- L - rz 5 Za-Al /,7 iui2 1/7 k
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION:
AddI work to be performed under this permit -check all that apply:
Zhanical — Gas Tank —Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: po
Cost of Construction: $ f�
Generator
Sq. Ft. of First Floor:
Windows/Doors Pond
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name A/S E A! . LL C
Name: ' vAes�1
Address: S91e:52 mot% .0
ompany: L.c�irime
tJAr'inoJ 4LAt'r-,n Ad
City: _D1 4 J145 State: 75C
Zip Code: 75-.2D o.!2 Fax:
Phone No.
Address: L
City: L
Zip Code: 3330 f
Phone No swl - 70v7
State: �L
_ Fax:
- Olo349
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail -D" i
6 Jm4v P LeaLkJOXA .
State or County License
_
If value of construction is 2500 or more, a RECURRED Notice of commencement is requires.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
S
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION: l
RESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
1 City: State: City: State:
Zip: Phone Zip: Phone:
j 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 isgranting 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 andcovenantsthat 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 th[s 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 attorney before commencing work or recardin ur Notice of Commencement.
/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA -�� 11
COUNTY OF `tt�
Sry n to for affirmed) and subscribed before me of
17
Physical Presence or� Online Notarization
this_ day of 2020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Commission
STATE
REVIEWS I FRONT ZONING
COUNTER REVIEW
RECEIVED
DATE
COMPLETED
actor/License Holder
COUNTY OFORIO
A.
Sw9� n to for affirmed) and subscribed before me of
if physical Presen a or Online Notarization
this day of 2020 by
Name of person maki7OR
ement.
Personally Known Produced identification
i Type of identification
Produced. _...
JULIA LOVtIRA
COMINILWON A GG6"ktion
EXPIRES Mari 1, 2022
RU INSURANCE) COMPANY
REVIEW 1 REVIEW
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REVIEW
blic- State of Florida )
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NOTARY
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