HomeMy WebLinkAboutBuilding Permit Applicationr
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: iZ"Z- 26za Permit Number:
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Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
I PERMIT APPLICATION FOR: q a a �.` ��
RECEIVED
Building Permit Application
Permitting epartment
Residential St. L ie County
DECO 2 1010
i PROPOSED IMPROVEME{�T`LOCAT10
Address: ` � 6 Q PeV o k 6 b1e S 6JVJ '�� �i etGe F%, .7 y
Property Tax ID#: ' 60"I - dp-1 0-,
Site Plan Name:
Project Name:
Lot No. 2 7
Block No. 12,
DETAILED DESCRIPTION; OF WORK `h
r ,
A
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION
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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:A
Sq. Ft. of First Floor: TOO
Cost of Construction: $ 20 6 Utilities: —Sewer _Septic Building Height:
:OWI\iER/LESSEE ;;.
COiVTRACTOR
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Name euoq 544cW
Name:
Company:
Address:;�f 0 q P4-so & Ues Uvd
City: P4. Airefce State: Fi
Address:
Zip Code: J?Vul Fax:
City: State:
Phone No. ,f-6 /- s 51-7V4 I
Zip Code: Fax:
E-Mail: ; qO Jf, J 4Jov1 hay e1 f . Coon
Phone No
Fill in fee simple Title Holder on next page (if different
E-Mail
from the Owner listed above)
State or County License
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.
DESIGNER/ENGINEER: Not Ar
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: T Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 1 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 your Notice of Commencement.
S' ure of caner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Sa- _ L.��'�-e
COUNTY OF
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 Zk, day of1Dj�-_ <.- 2020 by
this day of , 2020 by
`5at,3 aV-- 6g4-')5
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
roduced C- �i t--
Produced
7 E GNENS
(Signature of Notary P .o of Flo ' ISSION#
•••.. 1B.2p&'
(Signature of Notary Public- State of Florida
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Commission No.
ommission No. (Seal)
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20