HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:' I� Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
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PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: (0q)3 WOJS WO CA \ '(eK Gl(✓
Residential Y
Property Tax ID #: �- L `s " -7 Lot No._
Block No.
Site Plan Name:
Project Name: ' i a, I A L
u
DETAILED`DESCRIPTION OF WORK:
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 —Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch
T I S Ft of Construction Ia � Sq. Ft. of First Floor:
ota q.
n 2iln(� to _ Sewer _ Septic Building Height:
Cost of Construction: $ �f
OWNER/LESSEE:
Nam
Address: gaa) JA )ndS.,�anr4h Teh-eh
City: State:-R--
Zip Code: `3LJ0'15� Fax:
Phone No.��-�-lGlag
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: b(-ac %0t0Y' V E l( vleauVe-
Company:�"v`PU'C ��'n>✓t� ra
Address: �kg W,
City: �6 �k �'� t{et'� State:
Zip Code:'SHgS-2-- Fax:
Phone No30 Cq,fo3
E-Mail 1-1� nFt ✓� �+wl�llz�CoO�� �C�✓► 1
State or County 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:
Name: Name:
Address: Address:
City: State: City:
Zip: Phone Zip: Phone:
FEE SIMPLE'TITLE HOLDER: — Not Applicable
Name:_
Address
City:_
Zip:
Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
ate:
_Not Applicable
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
ructure. conflict
lease consult nw with your Home Owners Association landrreviewyyour dws eed for any restrits ct that
which may apply obit suc
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, con ult
with lender or an r-rr a ore commencing work or record' ur ice of Commencement.
Of
as Agent for Owner I Sof Contractor/LAcense Holder
STATE OF FLORIDA STATE OF FLORIDA '`
COUNTY OF 34ILT Q COUNTY OF ST' L-uGI�
Pw to (or affirmed) and subscribed before me of
hysical Presence or Online Notarization
t is L day of _IDFCp 2020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identificatio
Produc P irDel ico
fGc)TAR� PU r r 0 BLIC
(Signature of Notary
Commission No. a
REVIEWS FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
Swor to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this ,day of IJC)JC'MtW_C 2020 by
�fLCxirae�n V i Il�n��ay�
Name of person making statement.
Personally Known_ OR Produced Identification
Type of Identification
Produced,
b ( r dC3G165138 (' i nature of Notary Public- State a
Expires 1214/2021
(Seal) Commission No.C-1_
ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE
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OF FLOi
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