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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO 7UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n 1� Date: � � Z�Z'd Permit Number: l L 9 �;...`j'`'"- -mik 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: r. .ter -kti�'ss'�'? -:'"✓ 'j" iPROPOSE >N1 R:011EI1%ICNOCArCIO �I`"� Y � � � r � �t r .t _ I;�_M'`", .v'.,�.t.,.a- r. ..�r"..'!��:_ .. z. s �r..aiv;:a�'' n�.�.....�.,-r. .�:n1' 'art .: .�-r''r. ..� m, ' Address: J /tJ06 ✓ Property Tax ID#: Ifly- 701- 000Z-- 000 - 0 Lot No. Site Plan Name: 00D S X- 1-l"W4-t, 2-M Block No. Project Name: /��i S '�0 4) ! D .... - y .;Y`s '�.sy -a,�n'��y��.d:-:ga 'S'1. s�, ,�T� °;'�': �:zs DETAILEDwDESf�7101Q1?V�150 � KA � ���`.� T� 1'U C LU'D i New Electrical Meter Second Electrical Meter °3-x'C"` E" ..-r_w_.3v_�'v.,t.�:Y'tx.��'er�.k�:c'�^�-.��.ry',.�^:.�.�.�°��.�ar- �+_.�>. `xc'., rfri._�,rs 2..:. � :>-s�.�r.• ^."�=..,.�r+.r.xa.. -, .�. a, a��:� 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 Constructions: Sq. Ft. of First Floor: Cost of Construction:$ 1�.�© � Utilities: —Sewer —Septic Building Height: v �, `CNT %§mo� +AG � -i'�rFr'„d M€ Maw a ' Name r oze"r oD Z Ld 2 GOc Name: i l) Address: 6/'/� /'�,N4U/1 �� Company: / V t- City: sell( Ac Stater Address: d v P & Zip Code: C14 07 Fax: city: P . KeacrtState: Phone No. 27 U q 0 7 7 4�Y Zip Code: Fax: E-Mail: Phone No 2, Fill in fee simple Title Holder on next page(if different E-Mail DA U( P T)A V F CEO�JAN aam toy r C� from the Owner listed above) State or County License (i& q 9 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. *�`'^�;•rv;" ;fix�' s--^M;"'"'L;'�.�"" .�w���,a.5� ,` ti' r• ^a &wpngu ..Frnmm 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 OWN :Your failure to Record a Notice of Commencement m esult in paying twice for improvements your property. A Notice of Commencement must b ecorded in the public records of St. Lucie CountVrJn posted th jobsite before the first inspection. I y u inten to obtain financing, consult with lender attor be re commencin work or recordingo r Notic of Co mencement. Signature wner/Lessee/font for as Agent for Owner Signatu ofre of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA S 7— ,,& COUNTY OF -s�Z!�/�i� COUNTY OF6141 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 this Z,day of j(/b(T- 2020 by this��day of /'�(i 2020 by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Typetaf Identification Type Identification PrNnatuKe`*1rKcta_ry Prod c d (Si Pu " It1_a �. gna ure of Nptary'PUf7ti' dx� ,�,i �� RgHMING eoYPU95c LASHAH'VAINGRAiv}-RAH1�11NG �` �= MY COMMISSION = M {fiP? :Z r � a750&R Commission No. ) *i _ My Commission Nd.; E)(PIRES;Decem er 20� S:D f 0,20 1 -_ s 0nd d EXPIRE ecembe .2 22 �,," 8 E ru Notary public Under;,o'« i fa REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.5/6/20