HomeMy WebLinkAboutBuilding Permit ApplicationE
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO -BE ACCEPTED .
Date: �a,`���• Permit. Number:
RECEIVED
JAN 212021
R i
Building Permit Application Permitting Department St. Lucie County
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: C:�6�Un
Address: I' I c`_-VL_) "L3C`JV
Property Tax ID #: -
Site Plan Name:
Project Name:
New electrical Meter _Second Electrical Meter
Lot No.
Block No.
Additional work to be performed under this permit- check all that apply:
_Mechanical `Gas Tank — Gas Piping —Shutters windows/Donis _ Pond
Electric _ Plumbing _ Sprinklers , Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Lou)it �
Utilities: _Sewer _Septic Building_ Height:
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Name: -'-
Address:
Company::,,
City: v6Y�'oe-f Q`2- State:
,Address:
_
Zip Codek- (P 4_ Fax:
City:.- State:
Phone No 7-1raCM •Ws3 7 �J'W, Z 3
Zip Code: Fax:
E-Mail: ')')
Phone No
Fill in fee si ple Titl` older on next'p e ( if different
E-Mail
State or County License
from -the Owner listed above)
=1
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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DESIGN ER/ENGINEER: • + • • ' •e
Name:
.+GE . +NYo Not• • 0 le
'MORTGA
Name:
• •
A • •
city: State: 1.
• Phone•
city: -,State:
Phone:
SIMPLE TITLE HOLDER: Not Applicable
Name:,
BONDING COMPANY: Not Applicable'
Narne:
+••
Address:TEE
-zip.•
•Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby madeto obtain a permit to do the work and installation as indicated.
f certify that no %n ork or-insfallation has commenced prior to -the issuance, of'a- p'ermit:
St. Lucie County makes no representation that is granting a permit will authorize the .permit- older 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 wiil, i.n,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 radditions,
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:youur'prIop`erty-. 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;f nancing, consult
With Ipnripr nr an nttnrnpv hpfnrp rnminpnrina work nr rpcnrriinF your Notice of Commencement.
Sign f.OwneP/lessee/Contractor as Agent for Owner'
Signature of Contractor/License Holder .
STATE OF FLORIDA
STATE OF,FLORIDA
COUNTT.OF
COUNTY OF.,,
Sworn to (or affirmed) and subscribed before me of
,Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
is day of i��J 20222 by''
this _ day of 20_ by
Name of person aking statement.
Name of person making statement.
Personally Known_ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification -
Type of Identification
P oduc
Produced
(Sig ature f Notary Public- St
ignature of Notary Public= State of Florida,) '
Commission No.
�;Y'P�B�.,, DAVID E STOVER
Se aryPublir - State of Florida
aM-0
ommission No. (Seal)
Com .ix it s pr3,20MyCamm.ExpiresApr3,2021
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aN nalNosar Assn.
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mot
REVIEWS
FRONT,
ZONING
SUPERVISOR
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VEGETATION
-SEA TURTLE
MANGROVE
COUNTER
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DATE
RECEIVED
DATE
COMPLETED
Kev. 3/ o/ cu