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HomeMy WebLinkAboutBuilding Permit Application�11 m All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t� Date: Z420 Permit Number: 24 RECEIVED O . o NOV 16 1010 Building Permit Application Planning and Development Services pei ing Department 5t. �`11C1E CD1114?7y 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:�1 zs b C'.'9— k a# `' .1 l $ P '�' `,� 5�+3 Y{ '. a♦ Y H a '3M1 �1 h dd %1`X 1 ,y PR®POSEDIMPROVEMENT LO �gATI®N� `Fk ..�{?� i tr a Address: J Z p Q .3• � 74 ee 6-7' /b 7` 3 6 Property Tax ID #: 61"01 _ O© C0 — 000 1© Lot No. Site Plan Name: I-r7"9011'e, Block No. S:.eof 56 X 2.y New Electrical. Meter Second Electrical Meter 0.;.�-�� Additional work to be performed under thisspermit — check all that apply: Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond Electric )LPlumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: �, 3 S/4/ Sq.. Ft. of First Floor: /, 3 Y y Cost of Construction: $ C3 Utilities:Sewer Septic ` Building Height: ' f , t.®WsNFER, CONTRA r Y a Gx r �qZr TOR��� .Y a N a m ez�& xs�vyeA— Na m e Company: Z ' Add"'" 3z:oc�� "'� -�?� � �fC_��' fi' 3� 'City..,T� State: Address. S...` Tti S Zip Co8e- Fax: City: ��,�� i'c?/f�i Stater Phone No.. IV Zip Code: 39 0 2, Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page (if different E-Mail Rly � ,_�. . cy; State or County License 1 1//11 7- 3 13 6 from the Owner listed above) 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. p� �. 3r�d"..�:�-.; •�iT'S...� "'f+�5 F�i�} L. OKRA, �; , �; i r .E „ , v ,� �IL `ESN. , �':. �W. 'drNIF� �R1yJIP►Tf,N,. S ��,PvPLEMENTAI COENTR, UCTI®M �� € 3 �_�s4s��, M..-r..'..3 s'r„�lv^w.w-Sa:W,+.s,r,-+,.''.�.«, fir... DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: ���� f> Address: City: �i�✓f S ��i State:— City: State: Zip: Phone) d�'76yI' 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 restrictorprohibit 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 Iobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recordin our N,6tice of Commencement. . Sign a use of ner _eLadntractor as Agent for Owner Si ture of t is Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 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 day of 2020 by this day of , 2020 by Name of person making statement. Name of person snaking statement. Personally Known OR Produced Identification Type of Identification Produc ' """off••.. BRENDA ROMERO ZEUYA �g - tare o on (Signature of of ry VuElic or fv2 f I ;dn;GG208712 "rMy Comm. Expires Apr 18, 2022 Commission No. Bondedthr hw : ralNotaryAsm. REVIEWS I FRONT I ZONING COUNTER REVIEW DATE RECEIVED DATE COMP LET Personally Known OR Produced Identification Type of Identification Prod d (Signature of WotWryubric- State of Florida ) Commission No. :; %� •.. BR pWROZELAYA �F` Notary Public - State of Florida y Commissicn : GG 208712 Bonded through Na oral Notary Assn. ANUKU SUPERVISREVIEWOR I REV EW NS I VREVIEWON S REV EWLE MREVIEW