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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:X\�\� Permit Number: a (3 1 RECEIVED JAN 2® 2021 epartment Building Permit Application per St.Lucimingecounty. 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: "PROPOSED IMPROVEMENT LOCATION: Address: 1 2S Pc. ►� Property Tax ID#: 1 Jof _ Lot No. Site Plan Name: �I f Block No. Project Name: �E Y"►pp c, !� DETAILED DESCRI PTION,OF WORK: Joc>0 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: $ 2-S Q• r Utilities: Sewer Septic Building Height: OWNERAESSEE: CONTRACTOR: Name S Name: 3OV-0— u Address: 2.$ f f Company: YL ronGte� S L C L City: Pf a rc,, _State:L'1`5( Address: '9Z9U / i`�.�.-•� �..._r� Zip Code: Fax: City: Pod 0 State: )1z Phone No. '107- 411 — 11/0 Zip Code: 3K9 ?7 Fax: E-Mail: Phone No 77 Z'' 2l(- — /3 Y K Fill in fee simple Title Holder on next page(if different E-Mail IT(- - Cam+ "e pl-ra Mel. ce, from the Owner listed above) State or County License L/ omoo 2 8300 IL 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: RECEIVED DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _JN!jt?Aip Olga ble Name: Name: �srmittin� Address: Address: �E kk�slp r•nuntv 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 Counly/andjxr9ted on the jobsite before the first inspectio . If you intend to obtain financing, consult with leno/oro attbrney before commencing work or record' r Notice of Commencement. Sign rEOF of Owner/Lessee/Contractor as Agent for Owner Sig ture of Contractor/License Holder STA FLORIDA STATE OF FLORIDA COUNTY OF S-'• COUNTY OF S-*. Sworn to(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 z,-:'-- day of 2020 by this 0,6dayof 20201 by �5 o,l' ". Ctaoc.V-1 1-Nk-- C -f 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 'EL D1_.. Produced '�—'L— Q)L_ (Signature of Notary Florida _ Y (Signatur Fa©rids:„ _ '... `SPpY PU, E L L E N V SpPY P�� 4 o a�'� A U G H f�l 0 0% �1 (, __ :State of Florida-Notary Commission No. _2 �:stete bf k IVAUGHki Commissi =_ ��,kj 9� �P �anrmiss o d (Votary Public oFnoP�� My GG 27d07g (viy Co GG 27007g ��lit, GCommission Expires __... etober Peres --- 2, 2022 REVIEWS FRONT ZONI R PLANS VEGETATION SEATURTLE MANGROVE COUNTER REV( W REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 2