HomeMy WebLinkAboutBuilding Permit Application All APPLICAB E INFO MUST BE COMPLETED FOR'APPLICATION TO BE ACCEPTED19
Date:--Apr/ Permit Number: IN
SM LUC E, _
Building Permit Application -
Planning and Development Services _
Building and Code Regulation Di vision Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:.(772)462-1578.
PERMIT APPLICATION'FOk:
PROPOSED IMPROVEMENT LOCATION:
Address: Q$5`! S. Oce�vi 7J R. a ro -
PropertyTax ID#: 00 33- CSOD - S' --Lot No._- -aC?
Site Plan Name: Block No. `
Project Name•-
DETAILED DESCRIPTION OF WORK:
l'Y�Gf�f'.-fYl a rn d isConh ec f (,c/o�.S r'us Berl and• ��,•/e d. /1/0 . .'�o%� er
{Ze, Mefer: %fh /-r and �f►�/e, ONe �
CL►. ed- {pope C).,S L6 d re,c6,/—
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-
Y,Electric _Plumbing Sprinklers _Generator _Roof !Pitch
Total Sq. Ft of Construction* Sq.Ft.of First Floor:
Cost of Construction: Utilities: _Sewer Septic Building Height:
OWNERAEESSEE: IM CONTRACTPR;,
Name ' I� I 0LYJ=a� I • 1 e Ko ct
Address:. /0?51 ,S -ocean Dz-' aG Cor>3paFly dy��+7�U 1 ��eL 'r'l�t
City: �eylSeV� $e,aeh State: FL Addfes,�r la 93�r✓I/c�/, 5�rr�c e :/2,�
Zip Code: `S Fax: Citv, - ��S�tic�.r�-� y � State:
Phone No'." -719_ ro3'r - " -7o-7-7 'Zip Code: 3 Na`t y Fax:
E-Mail: Phone No 7-7oZ - qg6 - -7170
Fill in fee simple Title Holder on next page(if different E-Mail v7/dn e l ec lel e- ep g, ,•caft
from the Owner listed above) State or County License G C
u 7 3 I
If value of construction is 2500 or more,a RECORDED Notice of Commencem nt is required.
-
If value of HAVC is$7,500 or more;a-RECORDED Notice•of Commencement is-required. ----- - - - -
r3
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 subjectstructure
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 commencing work or recording our Notice of Commencement.
Sig ure of ,caner/Lessee/Contractor as Agent for Owner Sigrdture of'Contractor/License,Holder
STATE OF FLORIDA STATE OF FLORIDX
COUNTY OF vrlu I rr COUNTY OF in-
Sworn
to(or affirmed)and subscribed before me of §wgrn to(or affirmed)and subscribed before me of
Physical Pre ce or, Online Notarization X. ysical Presence or Online Notarization
day of 2020 by this day of 2020 by
�0 .i-®c
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Pers a y Kno n OR Produced Identification
Type of Identification- Typ of I entif tion
P duced / Pr uce d�t • �,''' � U010
_ a -
ignature of - (Signature — fe o o i a
• IHcwu�.wwwc = EPi `S:bcto 29,202
Commission �`Q i* lk�G275060 Commission No 4 •��``��
''' o;:• r tended Decerebet21,2022
REVIEWS FRONT - - ZONING SU OR'' : PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
-DATE
COMPLETED.
ev.