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HomeMy WebLinkAboutBuilding Permit ApplicationJ All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: ' Ca d�IC�OL C) RECEIVED °' p„ Building Permit Application Nov o 2 2020 Planning and Development Services Permitting Department Building and Code Regulation Division Commercial Residential sr Lucie county 2300 Virginia Avenue, Fort Pierce FL34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: 7�0.5v SO14kw 5 C0 n4(, (nR --Tn c- , Address: pWlb �t bce Property Tax ID #:5��' S� Site Plan Name: Project Name: 0 New Electncal Meter Second Electrical Meter Lot No. Block No. Additional work to be performed under this permit —check all that apply: Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors — Pond V/Electric Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: rCo o Co struction: $ Aq a1 D D Utilities: _ Sewer _ Septic Building Height: YS9 F f,..-.. �i AEI t Y�f1 �'T. ^f' �•'q• t��� �. � �'f} Si.}�C: OU1��IER/LESSEE}_t��n..7tx ,f.t pS� ty=N �.fi�`i� SG R'�',w' {i �����' "3 /�.' d¢F'# < 3 , 4f+. '^'�. lr }?. X CONT�RACOR +r: }w�;.,a#� Name Name: Aged, iC�L �j1`, '3 (( m_ : 4 S_610Oro CcNY�(GG�*Y�x 5c - Company� Address: WLk\o S, Ocean Q,-,ve �O�i City: epw(C ('�ecc'k State: CL ZipCode:3(R1 Fax: Phone No. Address: OS3 M\o -0bk Cc:,O Slue Z 1 City: 64'C4ye State:_C-L Zip Code:Fax: Phone No-?M-?)49-Gtb% E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail �uS�SGInGr� 6% •6�2�' State or County License%• I S: I qs,? a If value of construction is 2500 or more, a RECORDED Notice of commencemeni is requireu. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. � 't '� Sh �t y . t'..� , { h. � r� .; I p= L ` N, . R¢�C�TION IEN LAW t,NFOI Sit P P E E 'ar � i w :{a 1 t 5,�+., �a 447Y MATION ., . .iL,C M _T�► s� ... 4 �ry fL , . a' R s ,- .�� �..., 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 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 ..:aL 1......A,... ,._ ..r .,++...-.. i... N„;,.ro r^mmnnrinn Wnrle nr rprnt-tuna vnur Notice of Commencement. vvtut rctrucr yr arr aLwrrrc Signature of Contractor/Licens er Sign Aur ner - actor,as Agent for Owner o STATE OF FLORIDA C STATE OF FLORIDA COUNTY OFq . COUNTY OF -y Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization Physical Presence or Online Notarization ?his day of D �� , 2020 by this day of 2/020 by -J© t1A l,.1 -5�1� 'F LLf ��,_ 1rr e i - Ck _ 41 5�1 �1 Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identif ati Produced ProducedL, �� P IV LL, I (Si ure of Notary Public- State JULIEF.KIRKEBE ••• Ign ure of Notary Public- State of Florida ) .•'•,��Y'Pt' �) NotaryPublic- state,IFlorida Commission No. 0626 . • ) Commission # GG 0 96iom ssion No. ZZOZ 'Z t aun( ;^4 P` My Comm, Expires May7,2021 jjuxg ultuo� t78t7LOZ DE) # uolsslt.uu.1 °� •_ • Bond2dthroughNationalNrykin, ?� a; i � ''�rrri+++�` ,,d VE REVIEWS FRONT ZONING SUPERVISOR PLANS VE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED RY P �'�/ ;State of FI rida-notary Public DATE COMPLETED` r COmmiss on # GG 207484 ev. ­r �°�ri�°�O xP fires June 12', 2022