HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `� _ ° _ Permit Number:
1 L U C L L locate -� 33�- OOP"-2dY
_�J r
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential / 1
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT
IMPROVEMENT LOCATION:
rirlracc IL772 OCB., )2-, 4 `7S7 J-e,7se,7 ge-4 � �G 3y9h7
Property Tax I D #: ��//- 5-02 - 0073 - 0(20 - 61
Site Plan Name: —
Project Name: 7 7
DETAILED DESCRIPTION OF WORK:
— -4p e Ae
Q e: G,A /^IJOm
neM wa / 0 7-' y0Y s
New Electrical Meter Second Electrical Meter --�k--
CONSTRUCTION INFORMATION:
Lot No.-22273
Block No. O
e
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: �10 Sq. Ft. of First Floor: y�
Cost of Construction: $ /9oa..o Utilities: Sewer _Septic Building Height: 1 71
OWNER/LESSEE:
CONTRACTOR:
Name Geiu� �. d- ��C 41 u�oS
Name: r) i �ti
n
Address: 57
11
Company: �/�' J`1� b'00�� �l/G ✓>�•
City: &W174 hw.✓s�I,� State: AT
Zip Code: QY0 5'0 Fax:
Phone No. 110V-
Address:- d6/
City: Sn #,n j�l/� State:/—c-
Zip Code: 34/9Jr7 Fax: 772-232 -Zlgi
Phone No 77.2-160' 37/
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Gt d/a r,, f'ti "'i C
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.
SUPPLEMEN CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMP _ Not Applicable
Name: Name:
Address: Address
City: State: Ci State:
Zip: Phone ip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not icable BON COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
nxA/IUCD / rn KITD ArTnD ACCIrI\/IT• A.,.,1;—firm is ka—t— mnrlp to nhtAin a narmit to do the work and instalation 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 jobsite before the first inspection. If you intend to obtain financing, consult
%Aiith lanriar nr an attnrnav hPfnr*arnmmencing work or recordinLy vour Notice of CommeriLement.
AOwnerlsee/Contractor
Signs of as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLO
STATE OF FLO
COUNTY OF I V (l'�+ � 4'1
COUNTY OF r t1 r
Swoo to (or affirmed) and subscribed before me of
Swor to (or affirmed) and subscribed before me of
�hysical Online Notarization
y Physical Pres ce or Online Notarization
�c,
Presence or
1 by
this day of Uk L �, 2020 by
this K day of 0 2020
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification U S
Personally Known OR Produced Identification L F
Type of Ideptificati0
Type of Identificatio
Flo
Produced f-1 U �'t Gl K j� L
Produced —174
(Signature of Nbtary Public- State of FsoA49,
(Signatu of Notary Public- State of H ►daN, ►+�4RYLEE MA
i J c j / • io :..., t,� Mi4RY LEE MA
Commission N L`�* wCM1SSI0N#GG
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* * MY COMMISSION # GG
mission NoT_,& U�'��'` ',, I) EXP{RES:March6,
FOF
a EXPIRES: March 6,
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21 Flo Bonded ThN Budget Notary
M", Bonded Thru Budget Notary:
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20