HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
�' Permit Number: C2101 • o00 6
Date:
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p ° °., ."' 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:
3PR®�P. S�"LD LENT LO AT(O
_ _.A.,
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Address: 1/®�r�r
Property Tax ID #q S 2�-' ��®— Lot No.
: /
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Site Plan Name: Block No. b
Project Name:
ESa.CR= PTIN O° K:
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-ol- s1Gwe_. alal''�`"" Y*v %t-
New Electrical Meter Second Electrical Meter
GA
Additional work to be performed under this permit -check all that apply: %
Mechanical Gas Tank — Gas Piping — Shutters t Windo s/Doors _ Pond
Electric Plumbing —Sprinklers
L —Generator _ Roof Pitch
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Total Sq. Ft of Construction: / •S ,Sq. Ft. of First Floor:
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Cost of Construction:$ -Utilities: —Sewer —Septic Building. Height:
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Name 14X /�er�r�
Name:
Address: I-L-
Company: AP I
City: e' State: W
Address:
Zip Code: J--ib Fax:
City: I ' State:
Phone No. � d - — `
Zip Code: Fax:
E-Mail:
Phone No
Fill in fee simple Title Holder on next page ( if different
E-Mail
from the Owner listed above)
State or County License
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.
U;•. � L f EN � �L C � I��S' R �'al.®5-' 2 ..-�, .U1`I lN` � �R�' � ' °' -
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: — Not'Applicable
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Name: Name: ene.�� ��o,�i,Ci1/ . 14 C
Address: Address /D �-® �i✓ ��e.�'°os��
ate:
City: State: City:t�����
Zip: 7phone:
Zip: Phone 2Z
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,
rnccnry ctri trturas- 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.
Signature of her/ Lessee Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF tom. a COUNTY'OF
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
hysical`Pres "ce or Online N tarization Physical Presence or Online Notarization
this day202� by this day of 2020 by
Name of person making statement. Name of person making statement.
Personally Known _
Type of Identification
Prodmed
of Notary Pu
Commission No.
OR Produced Identification v _ Personally Known OR Produced Identification
Type of Identification
Produced
REVIEWS .I FRONT
COUNTER
DATE
RECEIVED
DATE
COMP LET
• �� (Signature of Notary Public- State of Florida )
LASHAHNAINGRAM RAHMING Commission No. •(Seal)
My ((�iI�WiSSION # GG 275060
EXPIRES: December 20, 2022 !
ZONING SUPERVISOR PLANS 'VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW . REVIEW REVIEW