HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 ad`a`1 _ Permit Number:
J �ICOUNTY
RECEIVED
Building Permit Application JAN 2 0 2021
Planning and Development Services Permitting rtment
St, Luc *nty
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 IMPROVEWNT LOCATLON:
Address: .'ZCy G/EG $
Property Tax ID#: olJo� �� 9- Lot No.
Site Plan Name: Block No.
Project Name: Sew
DETAtILED DESCRIPTION OF WORK:
601 r par
41MO I f' 1,�kCr-
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 Constructions: Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: '-CONTRACTOR,'`
Name &I L,!L.o Name: -JV-.e_ oye)v,
Address: 207 Company:�tLCorC�!-G P�y3
City: `Se y-Se State:a Address: S2$0 C7tt�-u...� l'�,•��� ��
Zip Code: 3Y T 5 7 Fax: City:A I"f 5-� All State: Izzrt-
Phone No. SS 5-0 OG 27 Zip Code: 24 q 8 `7 Fax:
E-Mail: Phone No ?7 Z — 24 —/.3 V &
Fill in fee simple Title Holder on next page(if different E-Mail Ile-, Co^tftfi44- , &J s
from the Owner listed above) State or County License L/3 DO00 Z $3
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.
..��, 'sir•-'FY i
-- UtiPPLEMENTAL CONSTRUCTION LIENk VY-4NEORMATIQ
.,,sr::
DESIGNER/ENGINEER: _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 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 Coun and esited on the jobsite before the first inspectio . If you intend to obtain financing, consult
with len orOattorne before commencing work or record' Notice of Commencement.
Sign atu of Owner/Lessee/Contractor as Agent for Owner Sig ture of Contractor/License Holder
STA E OF FLORIDA STATE OF FLORIDA
COUNTY OF S�r. COUNTY OF
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'4,� day of Zd�Ai�, 2020 by this 8W day of -Ja:r\ ,202(3 by
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 Produced �7--
Lyck ��OSAPYPG i ��OS RY dvi
(Signature of Notary Publ' State Ise _Srare LE nature of N - iC �'ate�o ri�(�
C °f�loN Vq OFFLOP�`� orr) �rr4'g.N OHfV
' ,A�W�C of»7 /ag; !d®•�l� (3H/�J „�nii��� N1Y CO
9slpn �rar P
Commission No. ,eal) MY C°, n#00"MoTpRi on No. m ,/as; it a�IIc
dot6 �s�/6/I 27o07g° " t°ber 2 Ekpi1�$e
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REVIEWS FRONT ZONING SUPERVISOR P- VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
�e_v. 5/6/20