HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �2.1 Q'N d Permit Number: a.0 �a -d 5o 4
RECEIVED
Building Permit Application DEC 212020
Planning and Development Services Permitting DepartmentSt. Lucie County
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:
d
PROPOSED,IMPROVEMENT LOCATION:
Address: SQ+nE -
Property Tax ID#: 2537--Secs—ego q,>_0C) )-2 Lot No.
Site Plan Name: Block No.
ProjectiName:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter X 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:$ r75O Utilities: —Sewer —Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name art' T/Locc,' Name:
Address: �Or-4 Company: __�GI-:- JT i hr
City: _ Fi State: F, Address: &1?lg --,w 117,-ore Ayc-'
Zip Code: 3 c(9u q ' Fax: City: r 1" 5y. Lucy r State: F-L
Phone No. Zip Code: 3'qc S 5 Fax:
E-Mail: Phone No _1 "72 S Lg,2(29
Fill in fee simple Title Holder on next page(if different E-Mail 43k w\c z Coon
from the Owner listed above) State or County License 3A1'VT
If.value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If value of NAVC is$7,5W 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 an attorney before commencing work or recording our Notice of Commencement.
(21,14 V___' aw� Z�'I
Signature of Ow r/Lessee/ ontractor as Agent for Owner Signat a of Contract r/License Holder
STATE OF FLORIDA STATE OF FLORI A
COUNTY OFF C f "C_ COUNTY OF 74. �,`t—
�Sw rn to(or affirmed)and subscribed before me of wo n to(or affirmed)and subscribed before me of
Phy$_ical Presence or line Notarization �bysical Pre rice or Online Notarization
this�L 1lday of J Y Ct/lE A ,2020 by t[isk- S day of e l 2020 by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identi ation Type of Identification
Produced Produced
ii Joseph Gomez
romffm�ilssion
ure of ry lic-StatV ) m (Si ature of o Public-St— of or dp) Commission 7#GG1614 04
w ; , Commission 0 GG16 -�`' '�= Expires:November 16, 0
No. �q:-••..� aTAireS:November;1 9(mmission No. Cb f �Oe�Sehtled thru Aaron Not in
p„gyp
onded thru An qary
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev.5/6/20