HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED,FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVED
COUNTY
Building Permit Application
FEB 0 9 1021
Planning and Development Services Permitting Departure
St.Lucie Co
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: �(,�cl '1c`1 D�.sfll1121
Property Tax ID#: —CO M 7�7J Lot No. `s►
Site Plan Name:- f a �' 4 ' in It Block No. 90
Project Name:
DETAILED DESCRIP.TION...OF.,WORK: . ,.
c
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 L,4-0of rZ., Pitch
Total Sq. Ft of Construction: RE!) L'�, Sq. Ft. of First Floor:
Cost of Construction:$ v �14 360 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CON TOR:
Name_L 3 C3 Lv �1.� c��_ Na
Address: GJk3P_, Com
City: '�c Q:N State:-7 Address: cal �-�1 S'�^
Zip Code: 3 T`1 / Fax: City::ft -V•I�f'Q,� Stater
Phone No. Zip Codev`1?,-;/ Fax:, `1.'7Z-C.,-9
E-Mail: Phone No 469 -0>�.b
� E
Fill in fee simple Title Holder on next page(if different E-Mail t R (2z
from the Owner listed above) State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. / �/� 1
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required. 1.I(I
SUPPLEMENTAL'CONSTRUCTION LIEN LAW. INFO'RMATI'ON:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone 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 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 the jobsite before the first inspection. If you intend to obtain financing, consult
witF
11@nder or an attorney before commencing wo ing your Notice of Commencement.
Signatu o wrier essee/Contractor as Agent for Owner igna L i c e—n—m roTder
P
S OF FLORIDA STATE OF FLOR',!0.
COUNTY OF - �Lc� COUNTY OF
Swor to(or affirmed)and subscribed before me of Sw5Vrto(or affirmed)and subscribed before me of
Rhvsical Pres ace or Online Notarization P sical Presen or Online Notarizati
this day of 2�2(YEiy this day of 29.2_ -y /
l
Name of person making statement. Name of person making statement.
Personally Known y OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced r Produced
(Signature of Notiry Pu (Signature of Notary
'vvys`, AUDREY B.HUM;PI TREY F.tSDREY i .3.3)317
=e°•' •F'. /�^ �G33`?a17 .-Y_5 u��c,, r..Fssieri •.;o I
Commission No. _ . MYCOi(S�e $IDPJ> ;o-• 1YCGiu• 63 ,,3
- 3 Commission No. ••. h `;
EXPIRE£:.,•3 a G.?_;,� PiRE�:taa ;,.. ttpp
.. _ l� -t: �, •a; E nu�.�-c 1)ndaC''�•- 9 St§
Bon
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGE ATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Te—v. 5/6/20
L