HomeMy WebLinkAboutBuilding permit app, updated the kw on the applicaitonAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6APYi 1 Permit Number:
97,
o
° ° p Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial 14 Residential ■][]�
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: ,r„11 [ � � f : z{ C1 --Ono
PROPOSED IMPROVEMENT LOCATION: C94 - z0�)q _
Address: 5'`)b2- u0►V.�lf Ln � }•• ►Q[ -� L a51 ^
Property Tax lD #: 1301 `� IS r.._� Lot No.
Site Plan Name:
Project Name: •40 f^ P. a---- .
Block No.
DETAILED DESCRIPTION OF WORK:
co (_rW -e_ YZ ki)- c,JKW -C -t 6 ri out 131-
� of o �Kw
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:
Cost of Construction: $ 5O)50 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name:
Address: ZS 5/-- Jvc&. 'Ao-t Company: Z��?uq Pi''l QX,r(,+LC'Plin�LLC
City:yb w '8�ea�— State: )c, Address: S3
Zip Code• 3ZCI410 Fax: city: (20(j- r.4, �C4�p_ State: L
Phone No. 7) D 5ia-l—W7��D .G►ct roll Zip Code: �k6 6' Fax: 7� "3sI i
E-Mail: Phone No '�_12 - T1 - 1560
Fill in fee simple Title Holder on next page ( if different E-Mail I()�U c � �a�d►�[tiC �Ut%�. , Lo 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DES16WENGINEER: 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 coo the worK and insiaiiau❑n aa,i,U 1LdUfU.
1 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 bu14d the subject structure
which is in conflict with any applicable Home Owners Association ru#es, 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 atto rney before commen cin warfc or recor ng Vou_r_o_i_ce Of Commencement,
All
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
LV--
STATE OF FLORIDA f
COUNTY OF �a
COUNTY OF
S rn to (or affirmed) and subscribed before me of
5 orn to (or affirmed) and subscribed before me of
Notarization
Physical Presence or Online Notarization
Physical Presence or Online
ra 2020 by
this L-� day of 2020 by
this day of
GL < n �e r
r'
Name of person making statement.
Name of person making statement.
Personally Known 9 OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
{signature of Notary - a o i a
RDrida
(Signature of Notary b�► ater> W iboofFrcrda
rsota,y Pub0c ate of
+g � ,yal ng*r i Aguier
Jenn"r I u' r
Commission No. MyCOMM4 e.G 339871
My G 33OS71
Commission No. ° 0 '
w Expires CW2212023
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
-
DATE
I-
COMPLETED
�ev.