HomeMy WebLinkAboutJ Austin Bldg App All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
L L L) t` L, ` Building Permit Application
Planning and Development Services
l
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:
PROPOSED IMPROVEMENT LOCATION:
Address: z '�o 0
PropertyTaxlD#: Lot No.
Site Plan Name: Block No.
Project Name: RU5 h
DETAILED DESCRIPTION OF WORK:
At) aI i ft t r l Cl rno el :-t-ri C� rho d r+ VP,wAN
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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: G�
Cost of Construction: $ Utilities: Sewer Septic Building Height: i
— —
OWNERAESSEE: CONTRACTOR:
Name . _ Name: ''o",_5 QI�I01�
Address: Y= i"� " / Fn .'2,'�" Company: i UJ herd
Cit 7
Cv��- 5tate:�, Address: �•b• t 7U
Zip Code: ;f ;� Fax: City: r State:'FL—
Phone No. - ~` _ '_ Zip Code: �2b�{ � ++Fax:
E-Mail: i it L% �, �`. c{� ?, ; _ , —• =,:' Phone No
Fill in fee simple Title Holder on next page(if different E-Mail erml �V) Jri20YiL419qAW, I M
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.
. . . - -1.- ....,. .1,
i ; .,,�': . -.:I
.- _ ..._- - - - . - _ _ -_
- ! _ .
. - - - - .. - . - - - -`: -
. -. __),Ir.. .
r ♦ - - -- --- .....-..-__ ._ - -. - - - --.�r-_ - - - - -- -
I . y .- - - -
,, - .. ... _ ,- 1.. .
L - - - - _ - '
-- - _ ,I.., _ .. _, ._.- I ... - - - -I. 7 - - -- .. - - - --
I f: , 1 - -
J' 1- . .1 f l t - -- .- - - _
- , ... _ _ _ . _.... '--- '-- .- 11- -
I, .,1, . I I"�"--�'f, �'�--. ,,.., - -..,-�,.-- . . - -�. I - . � � � .- I- I I .
�- 2 ..'. 1_ «I_ _ j
,1 -- - s -.. - - .-. - .. - � _ _ - ,
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: =IVot Applicable MORTGAGE COMPANY: r`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 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 our Notice of Commencement.
Si ure of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF g R+O F D R
0
m
Sw rn to(or affirmed)and subscribed before me of S orn to(or affirmed)and subscribed before me of N N
Physical Pres nce or Online Notarization Physical Presence or Online Notarizatio z M N
this day of 2020 by this day of .2020 by cD CD N
4't"
�s L,4 �~
Name of person making statement. Name of person making statement.
V Lu a
Personally Known y OR Produced Identification V Personally Known OR Produced Identifica on,,"':r'y
Type of Identification Type of Identification y:
produced Produced
(Signature of Notary i (Signature of No -
t�Ngtary Public State of Fbrid* v P' MARIA R.BURGIN
Commission No. `i I bra A r '� 'e`<;`
Miss
yCommissionGG928457 Commission No. ssion#GG(3 �
a pd Expires 11/03/2023 " Expires August 25,2023
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 0
r
� b�-.w"•-lam. <,_.:....: k� ��t ' I• - -
/I �•4• .'rj, s`::5�w� 4 �� - - - �:a <�., .. , y .�ti-.r •j fJ„� t{o, -
/`yam
tp
- '- FtrfrY�•-- -"'� •c lit .- 'il:.i. - _ �y - -,