HomeMy WebLinkAboutBuilding Permit Application i
All APPLICABLE INFO*MUST B� COMPLETED FOR APPLICATION TO BE ACCEPTED d
Date: J vZl Permit Number: a1d'3'
I
RECEIVED
• � MAR 0 5
loll
Building.Permit Application
Planning and'DevelopmentSeruices �ePStlttin9 count ent
v
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: �I Jri� ���JS l'o R5 1, 3
o
Property Tax ID•#: �Jy a�C — �3- �dsa—�O C1` 1 Lot No.
Site Plan Name: - L Block No.
Project Name:
DETAILEUDESCRIPTIO 10 F WORK: S Li 7'1+ , -S7L vice► 11 r7o
lock 1J /Ij!t�S. l�� ' -
������.�c� �G�rr.�� Dom'
51e,05 � A41-71 A51 5+t
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 _Roof Pitch.
Total.Sq.Ft of Construction: I Sq.Ft.of First'Floor:
Cost of Construction:$ Utilities: _Sewer _Septic Building Height:
OWNER-%LESSEE: CONTRACTOR.
Name d ..;�... Name: �•c Lie:s -7W
!-1= -
Address: s Cp- Company:
city: Td �`_ -Stated Address: g!,O-t? 6_-
City: Pi'S7--A4,o Gr- Stater
'Phone No. l "' &o d, z/ Zip Code: 3 SG f.5'2i- Fax:
E:Mail: Phone No '770,
Fill in fee simple Title Holde on next page(if different E-Mail e,&,1.S a v&ez met�H
from the Owner listed above) State or County License s I
If value of construction is 2500 o�more,a.RECORDS Notice of Commencement is required.
If value of HAVC is$7,500 or more,a RECORDED No ice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address: I
City: State: City: I State:
zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: ) _Not Applicable
Name: Name:
Address: Address: f
City: City: I
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the 6rkand 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 coriflict with any applicable Home Owners Association rules,bylaws or and covenants t at may restrict or prohibit such
structure.Please consult with your Home Owners Association'and review your deed for any restri Lions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respe s,perform the work
In accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendme its.
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 an her non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may resul in paying twice for
improvements to your property.A Notice of Commencement must be rec( I d in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intenid to'obtain financing,consult
with lender or an attornev before commencing work or recording our Notice of Commencement.
i -
Slgnatu f Owner/Lessee/Contractor as Age for Owner Signatu a of Contractor/License Holder
STATE OF FLO,1 IDpt STATE OF FLO� A
COUNTY OF ���e COUNTY OF �t--S �@
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 I Online Notarization
this s day of Ywo .20�l by this_e,�day of +! ! .20 '�j by
.s
Name of person making statement. Name of person making statei eni
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identificatio
Produced .t- Produced
(Signature of Nota .�,:� (Signature of Nota ubli -
• DEA NA GIY ENS
i►R ohry Public-Stagy orica ►� tic State of Florida
Commission No. < Cbmmissigg� r,85359 �Notyry Pu
d* my Comm.Expires 2a.ZOZ' Commission No. Com HH0a6359
Comm.Expires Jan 2a.2025
o:
" Bonded through Natil".Vc•.ri i� Ad''.' h►y h National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATIO F.A TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW'
DATE
RECEIVED
DATE
COMPLETED
Rev.
5/6/20