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HomeMy WebLinkAboutBuilding permit app All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 2 Date:1(�� Permit Number: RECEIVED 2T.[L alE p Nov 2 6 2020 Building Permit Application Permitting Departmenti St. Lucie County 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 I PERMIT APPLICATION FOR: c e.J Qf,.y - !'3h'Y+ _ '(�,,.L�3�F.y k K i'-• _5�M�:t`G.4?� {�`-0.�J.+.r iy}.tll Y,. OWN S s f,;1^st.'Cv awl. £ C:• �• s Cann j� ry��i 1t 12 r i, a q �� 'PR"bPOSED��IMPRO E�MENT LOCAsI'IOa r�' •, � `�+,� � r�` �t Address: �„�� obb le,slONC. 1/Q-1 ✓ Property Tax ID#: .2-3 .01e —(ea © 0/,97 o o o.— Lot No.��O '•— Site Plan Name: Block No. Project Name: New Electrical Meter Second Electrical Meter i t..^ s .;f�i- _"c,�43,�.r.� ;°r;,�l.=..<E`���vGy�it��:"� �'•?�w�. ,�-s�. ,x..xr'�,.`:.�'r �'*-;1... „�;...�r F ,c- -;�,:,e � •F "r, -a' t��.t r fi� 'If<„ :`"�1 `�,�, � 1��f„s��� > ter+ i✓�..�-.� .t-•y. ��` r.�S y" _ .t��:c"'.. rr+r.4:W. �. i 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 Total Sq. Ft of Construction: Sq. Ft. of First Floor: i Cost of Construction: $ 0 0 Utilities: _Sewer _Septic Building Height: ;:� Q'`, LKra' .,s,yr..b:,r. .c?..�`��c�',,.r'P r t�`' "� fit. �^•y. � 7�. =�'+y'^ T» y� �_ S.v�- *' h s=,. - .,_ Ok„W�N,ER/LESSEE.... yeti , � ? t', h 'a0_NTR/aCTORwx„. .z � ift�°, �� rl� 7.hC <...5�„_ ,�`„�a.. •+..i..,,.. �.3 �:. �t. ai_ �.'�._�,tCn.� ,l_.::..�r_--� >. t Name 0 Name: JeN /J fr; Address: og b eS.%0 Company:�/✓L1(/a�/bc/ City: D{� ! r-Gt�r State:_ Address:.3��9 �� 90! ems' Zip Code: �L�,� Fax: G� City:_�(Cf•P� V Stater Phone No. r2 goo 91 / Zip Code: .3Y'7 q Y Fax: E-Mail: eWJ '729 AR. MSN- C_0M Phone No 9(P 35 /Z J-S Fill in fee simple Title Holder on next page(if different E-Mail D�drl a'✓ L ZA'—aAnI from the Owner listed above) 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. i i r .:;.ttirn,-T�c�: . ,��'Y c'�„•;." Kam,-....a'.,�-.-^y.- -r-K- 'a q j:=s' � ;-r--��^-�u't,'3:"' '`- 'C:'''� 3z? iEMil, ~""'• W i ..2.. - t `SUPTPsLE(VI;EN' L CONS RUC'P61OrN LIEN W INiF'ORM/�Tt@-.. � �Fy= i / } 'Sa +r1'` �s..t"c" cr err i.*�r. rltom-..3;: cr.'�v'.`:. F'-.c5_`'. .'. •t:XYt..r:.'.a "v'.f,i`:.K. e.^ 7£.�d_3:�-.'- �Y rLsr :�K.i..,�' _�....r-� .-_.a. '���:Lr�`N 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 subjectstructure 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 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 a attorney before commencing work or recording our Notice of Commencement. Signature of Ow er Les ee Contractor as Agent for Owner Signature of Co ractor i se Holder STATE OF FLORIDA �� 11��1� STATE OF FLORIDA COUNTY OF COUNTY OF Swor to(or affirmed)and subscribed before me of Swoy+S to(or affirmed) and subscribed before me of Physical Presence or Online Notarization P/ h sical Presence or Online Notarization this QS day of M 0�7— 2020 by this day of Mom 2020 by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification✓/ Personally Known OR Produced Identification Type of ldentlfl�tian Type of Identification . rN Produced I Produced (Signatu (Si KAREN S. NIELSE "arP /,, KAREN S. NIELSEN �11111/,, �4P LB/i `�/ Co si pState of Florida-Notary Pubii al)- Commiss =State of Florida-Notar(�bl�lic - n 207484 fission # GG 207484 'b oc` My Commission Ex Tres ,'OFF My Commission Expires REVIEWS FRONT ZO I PERVISOR PLANS VEGETATION 'SEA7T7rr MANGROVE COUNTER REVIEW REVIEW REVIEW- REVIEW. . REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.