HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:`
Permit Number: aQ\1-6yya
§V RECEIVED
o NOV 18 2020
Building Permit Application
Permitting Department
Planning and Development Services St. Lucie Co r ty
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMI
T APPLICATION FOR a�\ YV\�
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PR9p�,P®SEDr111%IPR;OVEIV�°ENT�LOCATIQN f,....w.? .", .;�.r. w.. % N,t{�
Address: ?Z 0 6 3. ✓� /c,-r , -5-Cd
Property Tax ID #: K0%" e->O 6,0 - 000 /0 Lot No.
New Electrical Meter Second Electrical Meter
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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: /�!5�./4 Sq. Ft. of First Floor: %D �<
Cost of Construction: $ ` r, 5c!>.0 Utilities: i/Sewer JSeptic Building Height:
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ONT,RICTOR p�f ��
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Name
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Company; � & S
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City: ice' State: _,."1.-.Address:.?4-GCS
City: &a:�z State:
Zip Code:, % Fax:
Phone No. '772) <? x, /,y
Zip Code:`?Y�?f ?_ Fax:
Phone No -7-72!!5-
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E-Mail:
Fill in fee simple Title Holder on next page (if different
E-Mai1, )Zo,,v_ PD
State or County License _7 Zi/ 2 _
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.
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DESIGNER/ENGINEER: Not Applicable
MORTGAGECOMPANY: — Not Applicable
Name: -uJoa
Name:
Address:19' Su/&.0 7-Y
Address:
City: State:
City: oaf ��. /�rlle State: G
Zip: Phone??d 61R e 4-6 y'y
Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain,a permit to do the work and installation as indicate .
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Countt�fyylI makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which
ruture. Pleasecconisult withpyourHomeOwnners AssocAssociation
ation and review your deed for any restrithat
t ons which maor
aprohibit such
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 attorney before commencing work or recording our Notice of'Commencement.
Signa re of Own / see/Contractor as Agent for Owner Sign re of C n. rac icense older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �7� t�C�� COUNTY OF I U�f e
to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
1�10Physical 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 making statement.
Personally Known OR Produced Identification Personally Known -"*"- OR Produced Identification
Type of Identification Type of Identification
Prod ued
ature of N6tary Public -
Commission No.
REVIEWS FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
ev.
idaENDA ROMERO ZELAYA
NcryPublic Scnte of FloridaCommissions GG 208712,r MmrEzpi•es 4pr 18, 2022
M
Barlde� tfiP6ugh hadcra: Notary Assn.
Signa ure ry ublic-
Commission NO.
ZONING
REVIEW
SUPERVISOR
REVIEW .
PLANS
REVIEW
VEGETATION
REVIEW
BRENDA MARC) ZELAYA
MU, 0 GG 208712
My Comr . Expires Apr 18, 2022
Banded thyry qhN#onai Notary Assn.
SEA TURTLE I MANGROVE
REVIEW REVIEW