HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
83to LUL-LL
17 r 'Ci t` ( L, 2 _
Permit Number:
Building Permit Application
Planning and Development services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
Residential
PERMIT APPLICATION FOR: �� (d irlr7 t' aca-%) *t,rklre j
PROPOSED IMPROVEMENT LOCATION:
Iddress: 1320-1 S.-1P\8i6th 12iVe✓ 1)6Je
Property Tax ID#: LISOG-1%0-0012-0oo-0 Lot No.
Site Plan Name: Lt /--kki �Zt9 G10�G Block No.
Project Name: Lti761 a(YAA
DETAILED DESCRIPTION OF WORK:
�0,%d J LJrl 11 a IQ`a_ 1, 9__ 1 1
New Electrical Meter Second Electrical Meter
L 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 _ Roof Pitch
Total Sq. Ft of Construction: _ Z Sq. Ft. of First Floor:
Cost of Construction: $ 35, �i4 . Utilities: —Sewer ""Septic Building Height: 1°6
OWNER/LESSEE:
CONTRACTOR:
Name 0
k1Y1
Name: (� 2
Address Z0 S Z✓1diQl n 'El\ky- bnV
Company: (�
City: Jt.nse►n Teach State: F'L.
Zip Code: Fax:
Phone No.Lf,4Si
Address:) C OL
City: boloSDln State: N
Zip Code: 21D l-I Fax:
Phone Nocb(Ah fo'lo 14zo7 94 ZSps'
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
If value of constnlrtlnn I.7cnn ,.. ., o«
E-MailJU 5�br) . C do Pe I h q - 6 7-
State or County License Cge 125U422
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
MORTGAGE COMPANY: _ Not Applicable
Address IF
CA d�c -it
y ` Address:
City:�ub5� State: A&-,, City: State:
Zip:27/ll:? Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
--• �••r ��••.......+vn mrr+uvr r: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that noworkor installation has commenced prior to the issuance of a permit.
which is n conie Countflictawith any aes no pplicable )Home Owners Association) rulesabylaws or andpcovenants that may restrl tbor 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
with lender or an attornev before commencin work or recordin N ' f
our otice o Commencement.
Signature of Owner/ Le a/Contractor as Agent for Owner
Signature of Contractor ense Holder
STATE OF FLORIDA • 6tO`S3
_Y9iA
COUNTYOF DC&144,
STATE OF FtOR1B
COUNTY OFT),crt4AP,
Sworn o (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or_ Online Notarization
this day of
JG Physical Presence or Online Notarization
_ 2020 by
this _ day of _ 2020 by
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Commi io No. (Seal)
Commission No. (Seal)
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SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
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REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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