HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 14I/;?aao Permit Number:
"STA LUCIE
OU N-T'Y
r L O R 1 D A
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
Building Permit Application /
Residential J
I PERMIT APPLICATION FOR: I
Address: to 2-5- FienryS AA - Ff. P%crCC r F/• 3Y94�S
PropertyTax lD#:d3071 -Sol - 000V - 000- Lot No.
Site Plan Name: Block No. A
Project Name: no I i M a
IS'x 37' Gu+1I1K SvSMMIM4 r�o� 3'-S' bK<0
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit— check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors _Pond
Electric V Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 5$F ooCP .
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
City: Farr Pierce State: FI
Zip Code: 314145 Fax:
Phone No. T7e2-,20q- ILS43'7
E-Mail:_ a
Fill in fee simple Title Holder on neA page ( if different
from the Owner listed above)
Name:iRv&,.i . si&4K
Company: so—fA Flor'�n C4'f,1 R.,Is
Address: aGa.S SW Maap R4 .
City: PPc1., CI f- . Stater
Zip Code: 3YY90 Fax:
Phone No 77a' aSG 70 33
E-Mail nls �a.no-ii.Gor�
State or County License GRLlK5iw.
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.
DESIGNER/ENGINEER:
Name: RQJer M Aabur
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable ^
Address: V76 ow Ryaf Ar
Dr. Ma
Address:
City: TGASan 8.e"{
Zip: 34157 Phone 97D-M4-g496
State: f
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 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 jgbsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney befork commencing work or recording vour Notice of Commencement.
Signature of 0 ner/ Lessee/Contractor as Agent for Owner
Signat a trac i ense Holder
STATE OF FL RIDA 11
Mn
STATE OF FLORIDA
dCYi COUNTY OF
COUNTYOF M&lr4-in
Swo n to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
PhysicalPresence or_Online Notarization
�40'Physical Presence or_Online Notarization
this I dayof VaLer.6e-e 2020 by
this I dayof Decar-t6er 2020 by
6e,ACaA tWZPfaLLc'
RVLA _51ex'C
Name of perS�t n making statement.
Name of p rson making statement.
Personally Known OR Produced Identification f
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Produced Rr mensL ir-&.5
ProducedRODS
tae'oCom
(Signatur of ary ubli StateRM09
WililiE
f Notary Public- ii� IS�S�.IO...N.YJ.G�O24981
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Commission No. 1Sa�0 ofn 6NpYBlllblr4,2022202No.
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