HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: d _ -�"q Permit Number:
�'Z EWE
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:
PROPOSED IMPROVEMENT LOCATION:
Address: ��:5,3 ��`. �.
Property Tax ID #:�- �` / Lot No.
Site Plan Name: 5 �° ��n \ =1T Block No.
Project Name: WCL+e(— �r' `" wo
'DETAILED DESCRIPTION OF WORK
% r
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: $ Utilities: —Sewer _ Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name_ t i L` i ....,
Name: Cjl"�=sue Ci lc'
�y h
Address: 86.33 7—om%$C� pc, �'� i C C�
City: 1�C t _3 GLJC 1F State: V: L
Zip Code: ! �j� Fax:
Phone No. 235 — i' t
Company •At i�
Address:<;OUPA
ss
City: \ s 5® L'JCX'q State: �L'
Zip Code: ] Y / + � �7 Fax:
Phone No 772 — 33 !
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail'
State or County License C�� ��� 9 3,57
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.
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 th jobsite before the first inspection. If you i tend to obtain financing, consult
wit . r or an, attorney bef a commencing work or recordin a,nt it nr i, ^f
as Agent for Owner
STATE OF FLORIDA _
COUNTY OF �TL Lou e �
Sto (or affirmed) and subscribed before me of
V'Physical Presence or Online Notarization
this �� ay of '',�f tt VLLq 202# by (jam
Name of person making statement
Personally Known 1 OR Produced Identification
Type of Identification
Produced
Notary
.OR °'' DIANE COLE
Commission No. Nota b1 State of Florida
`. Coh1 k GG 461084
of n ; • My Comm. Expires Mar 14, 2024
REVIEWS FRONT I ZONING
COUNTER REVIEW
DA
DATE
COMPLETED
STATE OF FLORIDA
COUNTY OF S'.T t
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this � day of _IJA4u.(�s 2020 by
tlx-
Name of person making statement.
Personally Known 11.000" OR Produced Identification
Type of Identification
Prodpced
Signature of Notary Public- State of r" DIANE cot
Notary Public - Stat<
Commission No. t Commission b GG
My Comm. Expires a
Bonded through National i
SUPERVISOR I PLANS I VEGETATION SEA TURTLE I MANGROVE
REVIEW J, REVIEW I REVIEW REVIEW REVIEW
2024
Assn.