Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED � � � Ere P Permit Number: O 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: D T•_V 9 V A PR®P ySE�p R� .'a-� ®, _ N 11"Ig Address: a 1 W e s+ L AA °— Property Tax ID#: �_� '"��1 Q—�� ® ©®� Lot No. 0 Site Plan Name: / yolyIkAJVOIL SLtb eL"yj S/"vtv 0111 i %t I Block No. •3 Project Name: A yoAl MANOj.Z :o t: Lf L o®o New Electrical Meter Second Electrical Meter Additional work to be performed under this permit.—check all that apply: _Mechanical _Gas Tank Gas Piping _shutters _Windbws/Doors _Pona _Electric —Plumbing _Sprinklers _Generator ^Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ 11 �© Utilities: —Sewer' _Septic Building Height: OU1lNR%LESSE `� - �"r �p'TR ACTOR �, c' � � a s K rLs�ra� c ara `. ma`s r 5 }_ -., �.:� ti ;, a `- xt�s� Name "/�1�i c 'e, %Se'-in A/✓ Name: ►�.�✓��c lit (>a c4 ii Address: N ,�tlL' s ,Company: 'e ('itiew� } �ev�erQ ( Co/�Trf�C,�''� City �VGh`e, ei�,� Al, 1�• State:, G `Address yi?9� `s2 vac tJis�k �- ZpCode: ��`�f�/�o�`�� x: r aCity " a✓�FP$_ `- `L � State: �L Phone No. /r 7 72 Zip Code r 5 4 S` z Fax: E-Mail: Phone No -7?2--3`2, -7 `( 3 Fill in fee simple Title Holder on next page (if different E-Mail c1 Un 06 ^5'0-4-44-e,, s+ cz' �- from the Owner listed above) State or County License C Co C /Sa El 3 z S 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. SEEM 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. Inconsideration of the granting of this requested.permit,I do hereby agree that I will,in all respects,'pe-form.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 CountV,and posted on the jobsite before the first inspection. If you intend to.obtain financing, consult with lender or an attorneybefore commencingwork or recordingour Notice of Commencement. - rL— Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORt A STATE OF FLORIDA COUNTY OF Ly,, 2— COUNTY OF ST Ll.CGl� Swor (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�day of VecelnVNAj--= 2020 by this 341>day of DEL 2020 by ter. 0 Q.\ 1)0N DitN CM Name of person m=OR Name of person making statement. Personally Knowned Identification Personally Known _OR Produced Identification Type of Identification Type of Id ntification Pro ced Prod e ignature of t ry Public-State of Florida) Jda of Notary u ' /� Notary Public State 4P &N •Notary Public State of Floflde Commission Not�lT rJ n No. Kirnla( (gione +p�� Tracey R Mascola My Col�mles(On GO 957603 My Commission GG Expires 05/16/2024, E Ires 0412612024 REVIEWS FRONT ZONING SUPERVISOR PLANS .VEGETATION_ti S,EA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.5/6/20