HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TORE ACCEPTED
Date:. Permit Number:
A
Building Permit Application
Planning and Development Services
Building.ond CodeRegulafion Division commercial Residential
2300 Virginia'Avenue, Fort Pierce FL. 34982
-Phone::(772) 462=1553 :Faz: (772) 4.62-1578
PERM IT.APPLICATION-FOR:
PR`O`POS'Eb IMPR'Oa�%EMENT LOCATION} `
Address: �.�. i �► 4'.�.✓y Qi
•
Property Tax ID M. jjhL ! . 60.' 0 2 Lot No. .
Site Plan.Name: Block No:
Project=Name;_ an t'f4fte•ni�!►9.!
t
DETAILED DESCR'1PT.ION"OF WORK
�}:�
ti�T nr
New. Electrical Meter. Second Electrical -Meter
CONSTRU 10'N'11'NF RMATION. j Y
.Additionalworktobe:performed under this permit —ch:eckall .thatapp:ly:
_Mechanical _Gas Tank _Gas Piping Shutters: Windows/Doors : _:Pond
Electricrj5 y✓ ``;Plumbing. _ Sprinklers. _ Generator _ Roof Pitch
Total Sq. Ft of.Construction:! .: Sq. Ft.' of First_ Floor:.
Cost.of Construction: $.p d.� Utilities:. Sewer: Septic . Building Height: .
OUVNER/LESSEE f'`
r _. �..: _ ,_. :._.
CONT "AC�T,OR
F_...._.,�._ .. a
Name:
Address:.:"3)S .:V/+fi,64es.. A✓u .:Company:
City:. .. ZO e� 4- . - :State,.
Address:
Zip Code: Fax:
_State /
Plione:No.
Zip .Code; . fax:
E-Mail:.. :.
Phone. No .(` G ! . `Dl f2
.�Q
Fill in fee simple Title Holder.on next page (if.different
E-Mail c�Yl,rt
from the O.wner:listed above)'
State . or County License iL:�Z�60
4 J CA0
It value of construction is 2500 or more, a,.RECDRDED Notice of Commencement is required.
If valu'.of HAVC is $7,50U or ,more; a RECORDED Notiee:of Commencement is required.
,'S'U:PPLEMENTAL CONS, UCTION'�LIEN. LAW
I'NFORIVIATlO_N
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:...
Address:: :.. .
Address: =
City: State:
City State:
.Zip. Phone - .
Zip ' Phone: .
FEE SIMPLE TITLE-HOLDER: _Not Applicable
BONDING COMPANY: Not Applicable
Name:
.
Nam
Address:
,Address::
y •
Cit ... . .
City:.
Zip: _ . .. Phone:.....
--�
ZlP Phone:
-----�v �--• ,r...� ••• r,�.. nNN„K;duunls. nereoy maae io.00tam:a permit to do the work and installation as indicated•
certify that no work:orinstallation, has'comrhericed prior.to.the issuance :of a permit.
St. Lucie Countyy makes.no representation that is:gradting a permit will authorize the permit holder to build the ,subject structure
which is: in co with s with any: applicable Home:Owners Association rules, bylawor and covenants 'that may restrict or. prohibit such
structure. Please consultwith your Home Owners:Association and review your deed for any restrictions which may apply. "
In consideration of the granting of this requested perni'it,:l do hefeby agree that I_will,. in: all ,respects, perform the work
in accordance:with the approved plans, the Florida Building Codes and St. Lucie Count
y.Amendments;
The following bu)Iding permit applications are exempt from undergoing a,full eoncurrency 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:com- mencernent. must be recorded in -the public records of St.
Lucie.:Coun y and posted on .the jobsite.before the.first inspection: if you infend'to obtain financing; consult
with lerlde1r. or an: titt:ornev before commencing work or recording. our. Notice of..Commencement..
Signature of Owner/ Lessee/Contractor as Agent for Owner Si ature of Con ractor/License Rolder
STATE OF FLQ kffKi STATE OF FLORIDA
COUNTY OF ' COUNTY OF::
Syvgrn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
�ZSS Physical. Presence or. Online:Notariiation �X Physical Presence or Online Notarization
this 12day of Nose—K,1�e.S , 2020' by this 9u day of t�D•�w,,�ir'. 2020 by
_.
Name ofperson m`a_king statement. Name of.person making statement.
Personally Known/OR Produced.
Identification . Personally Known. OR Produced Identification
Type of dentification e�,e���°�° Type of Identification"
Produced \\\GPgEY M�°0° Produced:
(Signature of Notary Public -State of 1 r,'1,� ff(Signature of;Notar ublic- S a
r—" DANIELLE JEAN HANK
ommis o: lb 3� . Z.) �' YIv11SSI0N # GG 9 I
:.a� r t ommission No: 4. YS ('e
Z � .�4�s r ' �o; PIRES: Nday 23, 20
'�I M �. TF•.... �P:
of F4.• Bonded Thru Notary Public Und
REVIEWS FRONT ZONING�'°�R PLANS VEGETATION -SEA TURTLE MANGROVE
COUNTER REVIEW RE:.IEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
o"