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HomeMy WebLinkAboutBuilding Permit Application AII'APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I Date: Permit Number:_a l 03 nlQ,a S` LLCM �. L7 L. e r. Building Permit Application Planning and Development Services Vol" Building and Code Regulation Division Commercial 1% Residential 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: f Address: ®© Y M Property Tax ID#: ILI d 5 7 D 0 0© Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: �'�/� �� 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 V Plumbing _Sprinklers - _Generator _Roof Pitch Total Sq.Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ �. Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: /� CONTRACTOR: // Name �J ,,J A•4 a and a✓ Name: 6� z" /Q� G -441� Address: go ",CA:?_ 1tiW 12� Company:_ ��z /-G ��/y � /_Gc. City: State:AIV t Address: Zip Code: Fax: City: ,�. —State: L Phone No. Zip Code: 3�r1nn� Fax: E-Mail: Phone No .7 7 d� �;L Fill in fee simple Title Holder on next page(if different E-Mail ) 1, C from the Owner listed above) State or County License pr1 4(2-6 7 7 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 CONSTRUCTION LIEN LAW INFORMATION: 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 with lender or an attorney before com encin work or recording our Notice of CommenceMprit. Sig ur of Owner/Lessee/Contractor as Agent for Owner ure of Contractor/License Holder STATE OF FLORID STATE OF FLO COUNTY OF I e COUNTY OF r+ Vl C Sw rn to(or affirmed)and subscribed before me of Swoo to(or affirmed)and subscribed before me of h�sical Pres nce or Online Notarization hysical Pres a or Online Notarization this day of 202� by th' day of 2020 by 0--A I b AA)J r S 4(A' le Name of person making statement. Name of person making statement. r Personally Known Cq Produced Id ntificatio Personally Known OR Produced Identification e of Iden ti T e of Id Ific io r 11 Prpduced � rpduce ddd ill IN ]A aL (bigAture of No ary PublicPAat 6�grlda)DANIELLE D.JEWELL i ture o No ry uf�ilJ -St e:` "pia) DANIELLE B.JEWELL Notary Public•Slate of Flori a '_ ` Notary Public-State of Florid. Commission No Se6b mission#GG 937394 _+ ••�` mission N GG 93739 oFr+` '( m mmission N 'FoFr�° (SeS �" My Comm.Explfrs Dec 5,$D 3 My t�omm.Expires Dec 5,2 2 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA-TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.