HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
�V. LLUC L
P W. 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:
PROPOSED IMPROVEMENT LOCATION:
Address: L�'1 I t M r+ke- 14�-)T
Property Tax ID #: 34 Oo1- oS - op-Ig - 0 %g Lot No.
Site Plan Name: Block No. A —
Project Name:
DETAILED DESCRIPTION OF WORK: I
'flew i YN (00c WifldGwS izeplace w"o OMN- C,
04 Ipurrizt aro�n� �e .��ncStowS1rrg�all blew �mFxxc+ door.
W\(2 \et.vt\ av'& Vyor %crke.+( aL�Ck.�Ck reu ;c�r,oC
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical
Electric
_ Gas Tank
_ Plumbing
_ Gas Piping
Total Sq. Ft of Construction:
� sac
Cost of Construction. $ Do • e)o
Sprinklers
Shutters
_ Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof
_ Pond
Utilities: —Sewer _Septic Building Height:
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name } Q A Y E-
Name: S a a il-F) 'L S
Company: VAoSS6- f1�S nS+UC- 10o.1
Address: 1303h S-t-.
City: GtQer-hobee- State:FL.
Zip Code: 7149 7a Fax: 8103 710.3 (a Q
Phone No SCP3 7103 -755a
Address: I0a AYcLtec4- L-ane,
City: 014,eec holpee State: V:'L•
Zip Code: 349ILI Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
E-Mail l'f'►GS5e
' Wq1 /. com
State r County License
e)c— 1 1C3LA
if value of construction is Z5oo or more, a KtLUKUtU Notice Oi 4.0mmC""N"Wna m wyu I cu.
if value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
Name:_
Address:
City: _
Zip:
INEER: _ Not Applicable I MORTGAGE COMPANY: _ Not Applicable
Name:
Phone
State
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
Zip:
Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to 0o the worK ano lnstanauon as If1UIGd LCU.
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
: I- �__A__ ._ .� ++,....,,., l,e-F - e^w manrinn Wnrk nr rprnrding vnur Notice of Commencement.
WI111 lenuCI vI an auvi sic vv.v.., a..,...............
Signature of Contractor/License Ider
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF O .hoe C V) &>ee-
COUNTY OF
COUNTY OF
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
tV"day Qie C e M f , 2020 by
this day of 12020 by
this of p�e
Name of person making statement.
Name of person makingstatement.
Personally Known OR Produced Identification
Personally Known V/OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida )
(Signature of Notary Public- State of Florida)
Commission No. (Seal)
C i s'o N (Seal)
NoWy POW State of Floods
REVIEWS
FRONT
ZONING
SUPERVISOR
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VIE�i F9AJft(la 4 2SEATU TLE
MANGROVE t
COUNTER
REVIEW
REVIEW
R
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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