HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1a� Iaa Permit Number:
ao���ySS
RECEIVED
91r. 19(99LV-tz1A- DEC ® 7 1010
Permitting Department
Building Permit Application St. Lucie County
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:
Address:
Property Tax ID #: � 9 _ �'�� d �� , 3 d C-b �'N `".. - Lot No.
Site Plan Name:
Project Name:
Block No.
New Electrical Meter_-')< —Second Electrical Meter,
Additional work to be performed
Mechanical _ Gas Tank
Electric nLl Plumbing
Total Sq. Ft of Construction:
under this permit- check all that apply:
_ Gas Piping _ Shutters Windows/Doors'. _ Pond
_Sprinklers _Generator Roof !' ._ c Pitch
Sq. Ft. of First Floor:
Cost of Construction: $ 23 2S Z�l �'
Utilities: _Sewer \,Z, Septic Building Height: P'
Name / e . 6L
Address:
City: L �L��i-r� �'' ' ' State:
Zip Code: Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: ��� 5r fZ .A Rk4fl-
Company:P A-z� r.
Address:'- G
City: -ror _State:
Zip Code: ��(i�_T_ Fax:
Phone No ` o
E-Mail I ev
State or County License �� ��cs �/C
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.
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: — Not Applica ble
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 your Notice of Commencement.
re of Owner/ Lessee/Contractor as Agent for Owner I Signature of Contractor/Licen-Te Ho
STATE OF FLORIDA I STATE OF FLORIDA
COUNTY OF 4--*, COUNTY OF '--'k - 1,yc.\e
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
A_ Physical Presence or Online Notarization Physical Presence or Online Notarization
this —�_ day of pt <_ .2020 by this -_ day of 1% Q C 2020 by
f1Nc,-,a n �: "" Vv 4, \ I �A69 Q q p Vet tS q +C$
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced 'rc__�:P'L Produced 4D
(Signature of Notary P lic- State of � Ef
EN
(Signature of NotarylllubG '
IE GNE
Commission No.
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Commissio
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REVIEWS
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MANGROVE
COUNTER REVIEW REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
COMPLETED
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO. BE ACCEPTED w
Date: A *d a,,6 _ Permit Number:
.. TV5
Building Permit A licat on AUG
PP 2 0 2020`
Planning and Development5ervices ST. Lucie County, Permitting
Building and Code Regulation Division Commercial Residentia
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772J462-1578
PERMIT APPLICATION FOR: S ��
Address: I -
Property Tax lD#: e73 it7 Lot -No. 3
Site Plan, Name: Block No.
Project Name: _ li A,_J,0-Lg�s1 raj T.4r
Oft
��+
.a vr-n5 _
New electrical Meter Second Electrical Meter
Em-
$,r��k �i �� r'-1 -` 4 � �.'�'^..'�'':n,���. ""L.�, �=.�rv�
Additional work'to be performed under this permit — check all that apply:
mechanical _Gas Tank _ Gas Piping _ Shutters — Windows/Doors _ Pond
ectric `.PtGmbing _Sprinklers _ Generator — Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ .? lse► nr�� .
Utilities: _Sewer -Se Building Height:
a'`�EC1k ; �i^iz "'• F„'F,i''F`''�'"TLhi+ v""+v.$✓ *n 4 n.: N.4,a '
w..:i,a,F.,,.•c.-- ?.4:".;C,.II �4yf.ix . ,. rt,FE,�,v. ,y z i j�•{"1 „ + -zk �,. +{ ; $ �'�� kv..�.r * {� .,ry %C• ¢ ro
�rrw f�fj,IEti /' I�'
..,... Y'ri`+,�+f � ti �� ♦l�",�.�y+te �,r�G. �'„i' '?�. t,,f�C4 �'".�ti� �� '�r�: rr. �SF?s' Y a t `��q 4�'�v.
/ ��� e �..5�►�-Yi. L N am e:
Address: 3 2 / r
C''
City: ompany: .•. ' ,_. , :,
State:L... , Address:'
Zip Code: Fax: Cit
y State:
Phone No. `7_�'�c%3 fi?a Zip Code: Fax:
E-Mail:'I, - Phone No
Fill in fee simple Title Holder on next page ( if different E-Mail
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.
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 co mmenced prtor•to the issuance of a permit . ,-` " .
St. Lucie County makes no representation that Is! granting.a permit will authorize the ermtt holder to build the subject structure;
which is in conflict with any applicable Home Owners Association Pules, bylaws or•and covenants that may restrict or prohibit -.such.
structure..Please consult with your Home Owners Association and'review your deed foe any restrictions•which may apply:
In consideration of the granting of this requested-permit,.l do bgreby agree. that I will, in all, respects, perform tfle 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. ro1.om additions,
accessory. structures, swimming pools, fences, walls; signs; screen:•rooms and• aco69 ory uses to;another;non-residential' use
WARNING TO.OWNER: Your failure, to, Record a Notice of°Co errient mustbe recorded Pn the "publ c rrecords of St..
.improvements to .your property: A- Notice. of Commen
ohe jobsite bef6ee the flrst'.inspection:
Lucie Count Ifyou intend.to obtain financing, consult
d sted on t
with lender oanr an attorne before commencin work or recordin our Notice of Commencement.
of Own
STATE -OF, FLORIDA
COUNTYOF ' S�r•��c�e
as Agent for Owner
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this 26 day of g J� , 20_ by
`-zA7-,c,`. a --a ' 4 "s2'.Yy'- \
Name of person making statement.
Personally Known b0ediduced Identification
Type of identification
Produced�—
(Signature of Notary?ub,
DEANNA MAME GIVENS
Commission No4�
w MEXPIRESS'D0mbeGr16,2
20
E a� d 4P', Bonded Ttw Notary Public Underv+Aters
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 120_ by
Namd')f person making statement:
Personally Known, OR, Produced'Identification
Type of Identification
Produced
(Signature'of Notary. Public- State of Florida y
• . (Seal);:
Commission No.
REVIEWS FRONT ZONING
SUPERVISOR'
REVIEW VEGETATION REVIEW S .REV EVI/LE MRE IEWVE
COUNTER REVIEW.
DATE
RECEIVED
DATE
COMPLETED
,ev.