HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE IdFO,MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Mr RECEIVI50
LUCE
Building Permit Applicati n DEC 3 0 2020
Planning and Development Services ST. Lucie County, Parrnittlng
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: �t MQD(ZAX,r �� �� �� �o� �OJVS-C(WCt-(6A/
PROPOSED IMPROVEMENT LOCATION
Address: 1057-77 CD61 0-1 QUE
Property Tax ID#: 13caq goo -000 c CXx Lot No.
Site Plan Name: Block No.
Project Name: 0(2-A60m1JL VaSt0tiV CA-;
DETAI LED:DESCRIM. OF WORK
t,c. 040 . ,40 9' Mw f oweyL Poug ISU A mciva- w t1w
IV -C'kXCu--T PJ 'UtL 6 r tzCC'CFTAc FbA, e0'-VJtf.vC410'
New Electrical Meter Second Electrical Meter zoo - 03-3
CONSTRUCTION INFQRMATION
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:
ars
Cost of Construction:$ �Od ' Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE CONTRACTbR
Name A .r- t_. Q AA6,%4A tf Name: LA%AJ. ...
Address: qgi SL'J 2"r4 AJ4:� Company: M§Ofws !t xt � C.
City: VkJ>� 13,CAC k State:— Address: 2M QCAetJ
Zip Code: S2q Fax City: State:
Phone No. Zip Code: Fax: gLdt-TKO-,jtfL
E-Mail: Phone No U?
Fill in fee simple Title Holder on next page{if different E-Mail S'e(a'd'n. t , rd/
from the Owner listed above) State or County License l✓ � lY
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 TITLE HOLDER: _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 OWNE :Your failure to Record a Notice of Commencement may result in paying twice for
improvements t our property. otice of Commencement must be recorded in the public records of St.
Lucie County a posted on the o site before the first inspection. If y end to obtain financing, consult
with lender o n attorney befo commencing work or recordin o r tic of Commencement.
Signa own /Lessee/Co'ntraclarlas Agent for Owner Signature of Contractor/Licen a Holder
STATE OF IDA I l �� ) STATE OF FLORIDA
COUNTY OF COUNTY 0F �Y71
Sworn (or affirmed)and subscribed before me of Swop to(or affirmed)and subscribed before me of
Physical Presq ce or Online Notarization VPh,��+ 'cal Pres ce or Online Notarization
this 1c ay of 2020. by this4-?Aay of 2020 by
we / QR�. ,�l�.rfc, l�ru��
Name of person making stat m nt. Name of person making statement.
Per Known OR Produced Identification V1 Personally Known V//OR Produced Identification
Type of Identification Type of Identification
Produced 6y m- N%yn( Produced
(Signature 63f Notary Public- t i to ida) LUCIA DELEON ( ignature of Notary.Public-State Notary Public-State o Florida
L� o Notary Public,State of Flori a =' •= Commission 57
Commission No. Hen mmission#HH 37774 F My Commission E ires
( C mmission No. °;„(dal) May 14, 20
My Comm.expires Nov.14,,20 4
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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