HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COM
Date: i
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91r.LUCE
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Permit Numb M
REC
Building Permit Applicati
Planning and Development Services
Building and Code Regulation Division Commercial R
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
JAN 1 2021
permitting Department.
,i,AgtiLudgq Wnty, FL
PERMIT APPLICATION FOR: 5,�RQU '4
PROPOSED .1 MPROVEM ENT LOCATION:'
Address: 31 S 0 V2j" <a'Q WE/Y Ped Ne- rr-e _ FC . 3 t-1 C( t/ g
PrnnPrty Tax In It- 5 `7 I I i 7JJ- ,L . -r7 0` ) - 6 I 0 ` \ n4)D'I L-nt No -
Site Plan Name:
Block No. '7
Project Name: ®a eoJ
i
DETAILED DESCRIPTION, OF WORK, �-
Con <b a c -4 i e n O :e Q n �eu1
I �ggii+ , , 3 f1Z glI` `' rcwo
�jc-at l CQ ?-4 •P
I
i
New Electrical Meter ye5' Second Electrical Meter n Cz
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CONSTRUCTION INFORMATION.
s
Additional work to be performed under this permit- check all that apply:
Omechanical _ Gas Tank _ Gas Piping _ Shutters 1 ✓ Windows/Doors _ Pond
/Electric Y Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: �ci 1 p 5'q 1=-h Sq. Ft. of First Floor: 1q,j> 5:p r <
Cost of Construction: $ 37-1z oviro, crr— Utilities: _ Sewer _'Septic Building Height:+/
OWNER/LESSEE-
:
CbNTRACTOR:;. ,
Name okeri L Q O O-6fl F, a
Name: 11n. (C k�
w ea i-A iv
Address: 97 fo wild ®rU d 'LA.
Company: �G
I, �� ;e
City: Ew l- State: L�
Zip Code: 7q 611 Fax:
Phone No.
Address: X 0 1 II 5 cy �%.5 fj Lv
City: pd6-4 s�-. State: -EL,
Zip Code: Fax:
Phone No `7 72 , 62C " 3 / 7G
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail ,DSl 1 rn a - I . Cam
State or County License C 9c 12.0071
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 requiredll
SUPPLEMENTALCONSTRUCTION.LIE'N�LAW INFORMATION
DESIGNER/ENGINEER: _ Not Applicable
Name: 6-gy)C) , tn6-1\k Etc;n eea"
MORTGAGE COMPANY: _/Not Applicable
Name: i
Address: (VIA-
Address: i
City: I State:
City: f o r -l— p 1 e-r'ce- State: L.
Zip: Phone 7TZ,-TZi-179I1
Zip: I Phone:
FEE SIMPLE TITLE HOLDER: XNot 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
, c
which is in conflict with any applicable Home Owners Association rules, bylaws or andovenants 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 Country 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 jobsi before the first inspection. Iffy intend to ob in financing, consult
with lender or an or before mencin work or recordingNoti of mencement.
Signature of Ow er/ L, ssee/Cont ctor as Agent for Owner
Signat a of Co ractor icense Holder
STATE OF FLORIDA
i
STATE OF FLORIDA
COUNTY OF 5• . WcA-e
COUNTY OF Jr. LUC-! •e
Sworn to (or affirmed) and subscribed before me of,
Physical Presence or Online Notarization
Sworn to (or affirmed) and subscribed before me of
Y Physical Presence or Online Notarization
this 4 k day of L'itav-1 , 202p by
this (qt day of 202a by
Name of person making statement.
Name of person making statement.
Personally Known u OR Produced Identification
i
Personally Known)( OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
I
(Signs ure of Notary Public- State=RobinsLF
Commission No. 12G a` 2 al �COmml
I.
(Sign re of Notariy Public- State Notary Public State a( FI,
8212 Robin L Bowen
s ozitiarzoi3 Zee
ion NOGG a1 B ZI 2 ram ,e�>jp My Commission
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1
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20