HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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: GQze bo /?e- 2a0-P
PROPOSED IMPROVEMENT LOCATION ;
Address: /17 D Of) S• Oscan Dr(ve Jy ce) 1&4 Ch F L .3` q 5 7
Property Tax ID#: 4150 t — 314 - 000.E —0 1 0 Lot No.
Site Plan Name: Cta 2C 60 Block No.
Project Name: (TTQ7 b4 QQ - 44d4-
DETAILED,-DESCRIPTiCI[� Of,.WORK
NO- M¢1OfI tO metQl w,t— 1.�aand fIC -
New Electrical Meter Second Electrical Meter
CONSTRU CT OIti1;l 1U F,ORNtAT10N;,
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: 3 0 Sq. Ft. of First Floor: 330
Cost of Construction:$ (D , 17,5 O Q Utilities: —Sewer Septic Building Height: i i
OWNER LESS, CONTRA TOR,:"
Name N1 r0,dM6( ?OA lr%C. Name: M)IC 0 3• La ra-
Address: F0 13o)( 413 Company: TkOLl ?-46dy Srslty "TMKE
City: IenSM Qear,;, State: FL Address: t/t}O -5555��(aal�� St•
Zip Code: .3Uq SB Fax: city: Siva r 4 State-FL
Phone No. 1-f 2''41 0 - q ll(p _ Zip Code: 3gggl Fax:
E-Mail: OCCOVA { � ()( MtfalrU0� er7{/1$ 441 Phone No 772' y10� 9(f (p
Fill in fee simple Title H er on next page(if different E-Mail 4.1' M fA f iu pftc i(S.nC 1
from the Owner listed above) State or County License CC(, 1 3 3
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.
YV '! 3 �
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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 AppRcab4e
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 0 respects,perform the work
in accordance with the approved plans,the Florida auiiding Codes and St Lucie County Amendments.
The following building permit applications are exempt from undergoing a full coneurrency review:room add-lions,
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 fina suit
with lender or an attorney before comme
ncing work or recur cement.
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Sig n re f Owner/Less Contractor as Agent for Ow cense Holder
.STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 0 Q it n COUNTY OF tA a r+I e) n
i
Swam (or affirmed)and subscribed before me of . Sworn or affirmed}and subscribed before me of
Phy�ta{Presence or Online Notarization hysicai Presence or_online Notarization
This ZP day of - ,2020 by This 2$"'day of 2020 by
2 P1if4M4/ �D� Inc. -tic1fi. B• L�t�"n. -
ggc�n p3ame of person making scat nt Name of person making statement.
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Personally Known OR Produced Identification Personally Known OR Produced{dentlfication
hype of Identification Type of Identification •`
" Produce Produced S
ignatu f Nota ub[ic-State of Florida) (Si lure of Notary ublio-State of Florida}
Commission No. (A-Gr i 9"131 (Seal) Commission No. -7 3 IY [Sea[)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE I
RECEIVED
DATE
COMPLETED
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