HomeMy WebLinkAboutbuilding permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
a m
13 L D
Planning and Develo m Building Permit Application
Development
Building and Code Regulation Division
230t) Virginia Avenue,Fort Pierce FL34982 Commercial Residential
Phone: (772) 462-1553 Fax: (772) 462-1578
M
MIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:+ �
Address:
ram,
Property Tax ID it: Q -
Site Plan Name: 3- O��`
s
Project Name:
DETAILED DESCRIPTION OF WORK:
lc7 x l� s (ke
New Electrical Meter LJ Second Electrical Meter
r_�
CONSTRUCTION INFORMATION:
Additional work to a pe eJ_._1
_Mechanical _ Gas Tank
it —check all that apply:
_ Gas Piping
_ Electric —Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
OWNER/LESSEE:
Generator
Lot No.
Block No.
Windows/Doors _ Pond
Sq. Ft. of First Floor:
Utilities: Sewer _ Septic Building Height:
Name _a,lil�•p ZaN p
Address: OY_Gt. Ave
City' t State: �L
Zip Code S raw -
Phone No. ('
�-�— ��� ,
E-Mail: 1• .t >f' 1( o P 1( Vi 1 l�C-i�fv.
Fill in fee simple Title Polder on next page (if different
from the Owner listed above)
Pitch
CONTRACTOR:
Name: Tom Saurey
Company: Tuff Shed, Inc.
Address:1777 S. Harrison St, Suite 600
City: Denver
State: co
Zip Code: 80210 Fax: 303-474-5526
Phone No 303-474-5524
E-Mail licenses@tuffshed.com
State or County License CBC1253645
If value of construction Is 25W or more, a RECORDED Notice of Commencement Is required.
If value of HAVC is $7,S00 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: __ Nut App
Name: Rkh.d von -
Address: 1777 a I{-m.m slreel, Cub Goo
City: D--W State: co
Zip: emio Phone 3m-474 5u4 --
FEE SIM
Name:_
Address
City:_
Zip:
LE HOLDER: _ Not Applicable
Pho
MORTGAGE COM ANY: Not Applicable
Name:_
Address:
City: State:_
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone
Not Applicable
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 Counttyy makes no representation that Is granting a permit will authorize the permit holder to build the subject structure
which Is In onflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Pease 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 inspectioop�. If you intend to obtain financing, consult
with lender or an attorney before commencingwork or recgrding vour Notice of Commencement.
Signature' f Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORID IL - ,JG(.e
COUNTY OF 1
Sworn to (or affirmed) and subscribed before
Physical Pres rice or Qnline Notartionthis day of 202d blQ'xe+o
Name of person making
Personally Known OR Produced Identlf ai "
Type of lden ification o
Produced it kl�eC-C
•—U
n
(Sigi'lature of Notary Public- State of Florida
lorida )
Commission No. 6� " ° 'u ✓ 1 (Seal) i
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
5ignature ofTontractor/L&mr9-e Holder
STATE OF COLORADO
COUNTY OF D.,«
Sworn to (or affirmed) and subscribed before me of
X cal Presence or Online Notarization
this ay of -U-1 2020 by
Tom Saury
Name of person making statement.
Personally Known x OR Produced Identification o s
Type of Identification
Produced WA
t�
Z
O
% z �n
ignature of Itiotary Publlc-'State of Colorado) + m
o O
ommission No. (Seal) 'z I
Wmo
o �
PLANS VEGETATION SEA TURTLE MA N p
REVIEW REVIEW REVIEW REVIEW