HomeMy WebLinkAboutBuilding Permit Application1
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: D-� ' Permit Number: �!
�91T�v (uJ �Q� RECEIVED
"J,
DEC 2 2 2020
Building Permit Application
Permitting Department
Planning and Development Services - St. Lucie county
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: Tc*r NSPN 13 9iu� 3y9'%
Property Tax ID#: L�l� %J�'' 009- DODO Z Lot No.
Site Plan Name: *&uC / ,12'At>° Block No.
Project Name:
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
_ Electric —'Plumbing Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ &I oco
-Windows/Doors _ Pond
Sq. Ft. of First Floor: _
Utilities: —Sewer _ Septic
Roof Pitch
Building Height:
.a '}rr ye. t: - C e� ;1",l k h
� �, y�
OWNER LESSEE �ItZvilf'�
•3„�z; r%r` ° t" ['Jr`[S n '' 1 I'v" r� Ff . r
Name 0/0 �GLio�' �1(E,ti°R/1 /'�
Name: -A0,6611e! &,9RK
Address: fW 7.0't" ?Z4C6
Company: $'rXVCr Ar - GoIr1J
City: VXAL7 ,8Ar9EK Stater
Address: PD. ZF2¢ D d�cNflf3 {�
Zip Code: �z (Cn Fax:
City: 0; �Crr ►� r(f eE State:-15L
Phone No. 77Z W/ '5
Zip Code: 3q97 3 Fax:
E-Mail: . JV It G 1011,e e �`?"r4IC./'f . Cali
Phone No 7 7 Z 2 l r #Y /
Fill in fee simple Title Holder on next page ( if different
E-Mail Co
from the Owner listed above)
State or County LicensFOlol O 3 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.
SI�PPlEMENTAL CONSTRUCTION.LjEN
LAW
tNFOR'MATIOkN�
i"
VfY y;
DESIGNER/E -GINEER• _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: AIL 641mlraldUG MC.
_
Name:
Address: Zo n S7rR
Address:
City: firAt. N State: IrL_
City:_ State:
Zip:3zg6o Phone ri-L 45 125+7
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-attornev before commencing work or recording vour Notice of Commencement.
re of Owner/ Lessee/Contractor as Agent for Owner I Signature of
Holder
STATE OF FLORIDA I STATE OF FLORIDA
COUNTY OF _57" Laoz P COUNTY OF .S;7"' La<i p
Swo to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this-9day of-Z)A0PhA , 2020 by
Geaa 49,sCC
Name of person making stat ent.
Personally Known OR Produced Identification
Type of Identification
Produced t
(Signature of Nota7&�N
�4wotary Public Stab of Flodds
Commission No. hannonPUinell
y CommUt m 0 24a323
xalres 0811312022
Swor to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this c2L day of j)6 , 2020 by
8�
Name of person making stat ment.
Personally Known Produced Identification
Type of Identification r
Produced
(Signa i
Notary Publics StetsTG
!Comm
Fbrida
: Shannon aDon (S I)
er 0rpires G8/t3►2tsZ2 248323
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev. 5/b/Lu