HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COM`>=_'_ 13 FOR APPLICATION TO BE ACCEPTED
Date: /0410 &a Permit Number: U 0 — 1� C 3
ci�o dLlCUE' RECEIVED
NV,
OCT 2 12020
- PP LL, Building Permit Application Permitting)
St. Lucie Couepa�ment
Planning and Development Services nt v
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: Jrvo n, f�aooua7Yc N
Address: //? A/ Zoc &cts / Y- _7P,&t'/_.v / AG
Property Tax ID #: 4( .sa 1 s2o,wD -Ol/.S
Site Plan Name:
Project Name:
Lot No._
Block No.
DETAILED DESCRIPTION OF WORK
}
a F o .' v, .r.
t�
r r- A a e.d A oo4 2 9%5 47'fi La 7� Y D Q wr Ar w1 /7L►�
New Electrical Meter Second Electrical Meter
CONSTRUCTIC?N'I{NF"ORMATIrOIV rt
d k ✓r4
$�
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof Pitch
00
Cost of Construction: $ Utilities: -Sewer _ Septic Building Height:
;OWNER/LE SEE �
NTRACTOR
Name /z, 61
Name:
Address: 9/'/7 Al Ks"_T �/20e
Company:
City: Pis eu) A ,A State:/�
Address:
Zip Code: 199 7 Fax:
City: State:
Phone No. _<6 r 309 ! sYC I
Zip Code: Fax:
E-Mail: 77uLLCa c
Phone No
E-Mail
Fill in fee simple Title Holder n next page ( if different
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.
Name:
Address -,—
city- State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:. _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: State-
City:
Zip: Phone•
BONDING'COMPANy: _Not Applicable
Name:
Address:
City:
Zip: Phone"'
OWNER/ CONTRACTORAFFIDVfT: 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 permitp
St. Lucie County makes np representation that is. granting a permit will but aw or and covenaoli:14 to nts that may restrict uild the ar prect ohibit such
which is in conflict with any applicable Home Owners Association rules, y
structure. Please consultwithyouur Home Owners Association and reviewyour 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 failuire to Record a Notice of Commencement inay result.in. paying twice for
MprdVements 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.#tnroP-W w rivom . mencing work.or recording our. Notice of Commencement.
Signal Lessee/Contractor as Agent for Owner
STATE OF FLORIDA, .
COUNTY OF
so (or affirmed) and subscribed before me of
Physical Presence or Online Notar zation
this �tday of 7 20�y '
Name of erson making statement.
Signature of contractor/License Holder .
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
- Physical Presence or Online Notarization
this day of , 21)_ by
Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced � Produced
i m
(Signature of Notary Public -State% Florida) . :
(Signature of Notary Public- State of Florida. )
m y Seal
Commission No. (Seal) o o Commission No. i
Q LANS VEGETATION SEA TURTLE MANGROVE
REVIEWS FRONT ZONING SUP
COUNTER REVIEW R EVl!'��,�;� ,, EW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE