HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 20
�o LUCID
Building Permit Application RECEIVED
Planning and Development Services
Building and Code Regulation Division Commercial Residential DEC 1 j�20
2300 Virginia Avenue,Fort Pierce FL 34982 permitting Departmen
Phone:(772)462-1553 Fax: (772)462-1S78 'St. 6ueia County
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: M ''0
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
cfrl c - dn 00er
L4 rJ� rA 'lid. IWI:E4 IL Ald-J P eACE C.n-V1 ry d ✓dill v ,J 1.!�/d
q " fA1N -f,n ,42r1-L5 ,
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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:
Cost of Construction: $ 2 . V0 . Utilities: -Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name R���4S Name: Cs Moor,,
Address: _jjE&' S Company:_ $ . #70h r` rLt cft it L-L 0
City: or-T ff i Crc r State:& Address!: � I � f �r b oc i)C'
Zip Code: Fax: City: J6ro be- a L State: NL
Phone No. Zip Code: 11 '71a Fax:
E-Mail: Phone No 7 7 7 - 1 D LN I
Fill in fee simple Title Holder on next page(if different E-Mail M L E7 rj a J e L. !o ,a
from the Owner listed above) State or County License C G 3 d D ( 7
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 TITLEHOLDER: _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
with lender or aaanny/aattorne before co
work or re��coordin our cNootittiice of Commencement.
it/ {
Signal a of Owner/Lessee/Contractor as Agent for Owner Signature Of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S-F- COUNTY OF S F LUG:4
Swor 0(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
this,(,dayof Pee— . 2020 by this&day of be .2020 by
Name of person making statement. Name of person making statement.
✓ G�
Personally Known OR Produced Identifica Personally Known OR Produced Identification
Type of Identificatio ':s• Type of Identification
Produced % 5' Produce 2y�
(Signature of Notary Publi - Late of Florida ) 3 0 2 (Signature of Notary Public tale of Florida y
m�n3oD Com2
Commission No. (Seal) Q3� ='= Commission No. (Seal) m n3 o D
w30om c3y'T=
< w � a X11
m 3 - m
_ a rn o Z w
REVIEWS FRONT ZONING PLANS VEGETATION SEA TURTLE fUg R
COUNTER REVIEW REVIEW REVIEW REVIEW 6 �
DATE ^ '; I O
il
RECEIVED y n `cx
DATE
COMPLETED
ev.