HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date Permit Number:
14 2 [E
0
h Building Permit Application
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
PERMIT APPLICATION FOR:
I
IPROPOSED�IMPROVEMENT LOCATION:
'.
Address: �PAn4 �n s COA PceC(� ,F�iigEl
Property Tax ID#:_,j+-1�3'SDa-D1. �W-k Lot No.
Site Plan Name: AUtt(t,q " SOL,IF(L Block No._
Project Name: \Ou—ks -S(XAF-
DETAILED DESCRIPTION OF WORK:
:Yk,� � J solar SJSIc,1'I on
New Electrical Meter Second Electrical Meter
FONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doom _Pond
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq.Ft. of First Floor:
Cost of Construction:$ Locil(n�\\V Utilities: _Sewer _Septic Building Height:
OW N,ER/LESSEE: L_CONTRACTOR:
Name Jtca) _\occ6 Name: �f[i�,o.(1
Address: ,-'5m oalZ C to Company: QcAes�maL L\tA�rr,Cot Sa \kft MtC
City: 6k Uiz It State: Gl. Address: W ,Spi Ci \JlW3 UMtNP.C(E OC1�'`Jl e_3
Zip Code: 3y9Q I Fax: City: Stater
Phone No. Zip Code: awm1 Fax:
E-Mail:_Cjt&N\,A�A 14,cc.LaI Phone No is
Fill in fee simple Title Holder on next page(if different E-Mail s(9 1%Qcn&56M. fc"
from the Owner listed above) State or County License �,'�AYJ\biib
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: 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 06FFIDVIT: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 halde(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 or 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 7obsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorneybefore comment: work or recordin our Notice of Commencement.
gnatur�/Lessee/Contractor as Agentfor Owner �r o�ctorlucense Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF \I L1 uSn CI. COUNTY OF V Q\QA 1(L :
Sw In to(or affirmed)and subscribed before me of Sw rn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization hysical PresenEq oy_Online Notarization
this-2iayof 4.117N .2020 by this dayof N V 2020 by
zV�n YI uAt-ee n n �1�11A
Name of person making statement. Name of person makiin'g�statement.
Personally KnownOR Produced Identification_ Personally Know OR Produced Identification_
Type of Identificatio Type of identification
Produced Produced
ignatur of o - ( ignature
Ncbry PuWw Stale of FkmOa yY NC4ry Public Slero MFloliEa
Da 1 R Brekpp..��'1 Commission N Da I R Brake (` �"
COmm1551am No. MinMC 9�bJ2515 muwm G6 5
W ExD�ro6111t'!/IOYJ a,rveP Expa¢e 111171202J
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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