HomeMy WebLinkAboutJT Permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
pate:. Permit Number:
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;
�J a t S l
PROPOSED IMPROVEMENT LOCATION:
Address: l.V aaw' IAW airy- cSr. 'e�� 3 ! 9
Property Tax ID #: I - - UU I I - U OO - 7 Lot No. fl
Site Plan Name: S VJ : l(S Block No.
Project Name: L'i
DETAILED DESCRIPTION OF WORK: --------, -
Uc(
SC
CA
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
`
d Electric — Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ a yam_. Utilities: — Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
��E
Name:` ha " (r"ra.cccL c r
Address: VT- Ly. 41
Company: ► d�� , f r
t e 5�
Address: K f
_
City: ��trr �, LVCrC- State: A,
ZipCode; Fax:
City: State: (' /
Phone No. 777- - (o o 0 Z
Zip Code: 3 (49 5_" 5 Fax:
��
E-Mail: t4r,44C A.S H Foe f 452 4f:g" _ ,&!!A
Phone No 73 ?
Fill in fee simple Title Holder on next page ( if different
E-Mail LDEC-o
from the Owner listed above)
, c.9 en
State or County License Apr_ wl S► �Lc� _
is required.
If value of construction is 2500 or more, a RECORDED Notice of Commencement
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement
Is required.
I
"••"'I " s I uR APHUVI 1 : Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that noworkor installation has commenced prior to the issuance of a permit.
which is inc ortWi t makes
th any applicable iHoeOwners granting
permit
r will
bylaws or and covenants that may restrict estnct or prohibits structure
structure. Please consult urnth 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.
Lu d posted on the jobsite before the first inspection. If you intend to obtain financing, consult
ith lender or a attorne before commenci�workk or recordour Notice of Commencement.
Signature of Owner essee/Contr ctor as Agent for Owner I Signature of Contractor/License Holder
STATE OF FLOAfDA STATE OF FLORIDA �}
COUNTYOF_._ � LuCte, Ii COUNTY OF %%��►^^ '�2��Ch
Swyrn to for affirmed) and subscribed before me of ! Swo to (or affirmed) and subscribed before me of
✓ Physical Presence or Online Notarization ✓ Physical Presence or Online Notarization
this day of NOVQM (2020 by this 4 day of _ j anoe-r �_ 2020 by
3CLMes U--)+1ls 4
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 I Produced
(�J#ndture of Notary Public- State %Florida J
vp
Commission No.&(';DDAt9 *'9
REVIEWS I FRONT I ZONING
COUNTER REVIEW
DATE
RECEI
N�ef
(Signature of Notary Public- tor y . vt;1.c State a Florida
STIftNIE N H WIN . Traci veiez
* CornmL%ion 1"+ mission No. � iuron GG 937771
or Exp,res 2+08e2023
r ExPIM J* 16, 2022
ffi+q* Sevlca: --
SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW