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HomeMy WebLinkAboutBuilding Permit Application All APPLICAB(L�E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ©,/I �A a ��� Permit Number: o�(00Q •0021 GQWN > w Building'Permit Application 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: L /31/V& �R�PQSE�'(MPRO, EMF,,NT_LOCA ` JV Address: / 97f� 0!C 4 ve7Olnc&�— — Property Tax ID#: l�Z3 17030 Q 711)®O 3 Lot No. Site Plan Name: Block No. Project Name: bETt ILED DESCRIPTION OF W(3RF _. New Electrical Meter Second Electrical Meter Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond _Electric _ lumbing _Sprinklers _Generator T Roof Pitch 'total Sq.Ft of Construction: Sq.Ft.of First Floor: ©a Cost of Construction:$_ �_ Utilities: —Sewer —Septic Building Height: °OWNER/1>-SSJEJr . , CONTRACT+O#3:. . ... Name �/� M /l 2/a L� �Ay Name: Address: tO/ -3 Company: City: 1Z7_ - State: Address: 1;�2L,2 J5 L M4P -20L Zip Code: 9 Fax City: l? .S.•�-- - State: Phone No. Zip Code: Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail /� �LU/�B��G„�/� �/ /L• from the Owner listed above) State or County License A;r-7�o 6 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. SUPPLEMENTAL CONS RUCTION I j14 LAW)1�9FORMA l0l f; ,... __., . 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: JZNot Applicable Name: Narne: 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 with lender or an attornev before commencing work or recording o Notice of Commencement. Sig ur of Owner/Lessee/Contractor as Agent for Owner Si a re of Contractor License Holder STATE OF FLORIDW, STATE OF FLORIDA COUNTY OF COUNTY OF Swo'pirto(or affirmed)and subscribed before me of Sw�to(or affirmed)and subscribed before me of Ph sical Pres nce or Online Notarization _P ical Pres ce or Online Notarization this�day of _,2020 by this /day of��—,2020 by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Iden "fication Type of Identification Produced P74, rodu I! r (Signature Notary Public- ridat4ry public•State of Florid ignature Notary Pu c= 0c-State of Florida ` Commission#GG 349970 yG `' Commission#GG 349970 ° 1�+ �Q m.Expires Jun 30,20 3 '�bF�° My Co E�p(res Jun 30,2023 Commission No. "'0FF`"'' Bond�d' �bLgh National Notary Ass , ommission No. nded throBgTfth onal Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.5/6720