HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
g T. LLUQDE
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: �161?�
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name: `Tb&2e.YL.
DETAILED DESCRIPTION OF WORK I
New Electrical Meter Second Electrical Meter
ONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors _ Pond
Electric _V'Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ l.(S%. Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name:;-)
Company: e
Address: -�IIVR3
City: (�'_ State %
Zip Code:117OR Fax:
Phone No. - -12 ^ ,S --//2 5:
Address`:
City: ._4..g12 Z0�
Zip Code:3L1q 7 Fax: 22,5--
Phone No '77,21 -,r2',5 -ram 60
State: ��-
& `/72
E-Mail:
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
E-Mail :L-JeAssca IJu@!
State or County License cif
l lYl'� 7i'
IT value or construction is z5UU 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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
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, 1 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 an attorney before commencing work or recording our Notice of Commencement.
gnature of Owner/ Lessee/Contractor as Agent for Owner
Sig ure of Contractor/Li se Holder
STATE OF FLORIDA
COUNTY OF In is-TIr'l
STATE OF FLORIDA
COUNTY OF mCk r-)
Sword to (or affirmed) and subscribed before me of
V Physical Presence or Online Notarization
this day of ,�2020 by
Sworn to (or affirmed) and subscribed before me of
hysical Presence or Online Notarization
this day of 12020 by
y
1--dV'� ►1 � C' 'I, t c e "Yst
_ n it ki Cat - r ,, cn
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 Identification
Produced
Produced
t
( ature of ry Public- State of Florida)
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No.C� R75q& (Sea
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Jp��c 9`a°�eGG2'15
(S ature of ary Public- State of FloridaP
-Commission 2F2�O�`5p6A
ommission No. GG 27 ry"oG2G
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REVIEWS
N aG�y o
FRONT Nry��
COUNTER 2 E'p
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SJ SOR
VIEW
PLANS
REVIEW
VEGETATION
REVIEW
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JRK
MANGROVE
REVIEW
DATE
Ot
RECEIVED
DATE
COMPLETED
ev. 5/6/20