HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ' Permit Number,,
Building Permit Application`.-
Planning and Developrnent Services
Building and Code Regulation Division `COi'Y1171erCial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:_(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR: .
PROPOSED IMPROVEMENT LOCATION:
Address: 316 golllA I'1VP� for-" Saen+ L_Ltc I e FL 3u95a
Property Tax ID#: 3y jq 5-10=ba5-a " O00' a Lot No.
Site:Plan Name: ��C a 1 f n SK�S 1 d P�nCQ, Block No.. :
Project Name: 1. t cn S (nL.Ptc l�Q,n:C Qi,
DETAILED DESCRIPTION OF WORK:
Erna �x��'rina M2 ,C Car_ wear 2c fn�a�► . un� PE' �o Amp
_ f -
OVeI` VicP,`1-o undek-grour2o�
New Electrical.-Meter_ ./ Second Electrical Metes '
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: - 45'0
Cost.of Construction:.$ ' Nl9U 6O Utilities: Sewer _Septic Building Height:.
OWNER/LESSEE: CONTRACTOR:
Name rns Name: dweied S �
Address:" 31(0 �o,1)y. V� Company: E. Sm i ih ef2
City: For 5a;nLuG1-C State:CLL Address:_Sa 0-7 '0n kJ •�d •L k k it
Zip Code: 314 q 5A- - ,Fax: . City: - - -
Ph, :57o110 Zip Coder 3Q 9 / Fax:
E-Mail: - Phone Noasfo
Fill in fee simple Title Holder on next page(if different ; E-Mail e_ Si»i 7t'fti S P r'V/LG I Q/Tt a, /Jy
from the Owner listed above) State or County License PC l3 0 O gtyzz7
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 Y'
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.
1
Signat e f ner/Lessee/ ontractor as Agent for Owner Signature ci Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF " .J-. I r tr h& COUNTY OF S+, Ly d t
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
>0 Physical Presence or Online Notarization Y- Physical Presence or Online Notarization
this 01""day of 2020 by this (vt� day cif kJ oyefA.6d-v 2020 by
�l�unv� SMAIA
Name of person making statement. Name of person making statement.
Personally Known)Q_OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Producedp j„*L leSZ-6 l b-7�"7Q 4-0 Produced n . 1-1
40 Notary Public State of Florida
aF Mona Leon
My commission GG 230893
(Signature of ota PIWI (Sigrtature of Notary Public-St
�,ra•/4 Notary Public State of Florida
•
Commission No.. Emily N Hi s ,
y Commi 037541 Commission No. ��2�z$9 j (Seal)
or a Expires 08/30/2024
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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DATE
COMPLETED
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