HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ['7n
Date: Permit Number:CQ
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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:
,PROPOSED IMPftOVEMENTLOCATlQN ,�arvam
Address:_-_y 116 1J A A l Y Pi f l 3YQL49
Property Tax ID#: �y2� �3�1�1/� I� Lot No.
Site Plan Name: p� Block No.
Project Name:. occan�iauc condo
DETAILED DESCRIPTION OF WO€RK
1Glc,�. L �C—t c�ir-Gl��c-��2 � NCq� 20--01b-1• C�5
� car is 10�1 [a on N0(-VY) SjCaG O� OIO►Y1�tYl� � L
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION .. r
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: Sq. Ft. of First Floor:
Cost of Construction: $ L4 L4 yC-) •oD Utilities: —Sewer _Septic Building Height:
=OWNERJLESSEE: ` CONTRACTOR '`
Name Otic-6711 rleae ." ' ^1 I Name:
1 Address: y 7 l�
� s e
City: r+- p1 CrCG Stater Address:435 nu-')
Zip Code: SL-1gy Q Fax: City? c`s1 LL-- State:FL
Phone No.-n2. $0) . )211v Zip Code: �5LkPiSID Fax:'7-IbAkep•-Ilo-Z-6
E-Mail: Phone N 77%- 4 LoO--q(o�!)Z
Fill in fee simple Title Holder on next page(if different E-Mail e S 4
from the Owner listed above) State or County License
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.
�SUPPLEM.ENTAL CONSTR-UCTION LGEN 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
ender or an attgney before commencing work or recording our Notice of Commencement.
( - os::t:� Q�lv
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Signa ure of Owner/Lessee/Cohtract r as Agent for Owner Signature of Contractor/Lie se older
STATE OF FLORID, STATE OF FLORID
COUNTY OF - �^� ��Ci COUNTY OF II n r L JC1 Cam.
Sw rn to,(or affirmed)and subscribed before me of Swor t and subscribed before me of
Physical Presence or Online Notarization sic Prese or Online Notarization
th is30 day of 2020 by this day of BAY 2020 by
Name of person making statement. Name of person making statement.
all Known OR Produced Identification Kn . OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-State of,ogida) (Signatur of Notary Public-State of F� .f�
�,..�..e�c MICHAEL WAL2'AK ° Commission#HH 7 1
l4 C C mmission#HH087 Commission No.��qq Qv, ,M.'f,
�1) February
Commission No. * 9eal�° :4 9 097 I 1 . * Expires 2 2 5
Expires February 2,202 Eonded nw
�FOFfi� 6ondrd7fw Budget N*1WS s
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.