HomeMy WebLinkAboutBuilding Permit Package All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:3 3 b 0al Permit Number: O 1
9�o[LUCIl< RECEIVED
O Az
_'` Building Permit Application APR m 6 2021
Planning and Development Services
Permitting Department
Sc. Lucie Ccurrt•;i
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578
I
PERMIT APPLICATION FOR: '
PROPOSED IIVIP.ROVEM,ENT,LOCATION
Address: 3 3S Property Tax ID#:�3�7- 744'00-87—006 Lot No.
Site Plan Name: Block No.
Project Name:�
DETAILEDFD.ESCRIPl"CON OF V1/ORK:'� � � _
-new-,
New Electrical Meter Second Electrical Meter
_CONSI"RUCTION,INFORMATION =
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: $4��7�. 0o Utilities: -Sewer _Septic Building Height:
.OWNER%LESSEE CONTRACTOR t
Name .1 Name:
Address: ..zU4,3t-. tle,)s Company:
City State Address:943 • A,yJ � i�2t�...
Zip Code:,?449,6/ Fax: City x'.cA Stater
Phone No. Zip Code:3y9y,5 Fax:�G/-� 778'
E-Mail: Phone No=- !&/-4?727
Fill in fee simple Title Holder on next page(if different E-Mailm; if Da i Je.- a h-ghlaaL - Gorr,
from the Owner listed above) State or County License 66 1264 - 58-5 9
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.
UPR}i.EM E�N LAW INF,ORMaTDN NSTU0 (ENTA GOCT ; 1 y 4 _ �3
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: 3e 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 poste n the jobsite before the first inspection. If you intend to ain financing, consult
with lender QL an atto a efore commencing work or recordingyour Notice o Com encement.
Sig u e of Owner/Le ractor as Agent for Owner Signat e fff'Contractor/Litns Holder
STATE OF FLORIDA // STATE OF FLORIDA
COUNTY OF ��l �e COUNTY OF CGIL'`C%
Swop to(or affirmed)and subscribed before me of Sw to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Phy$'ical Presenceor Online Notarization
this�L�i a of M 202p by this jSIvday of 2029 by
ellAgz- A,et oLr olla-6 &_ ®t
Name of person making/statement. Name of person making statement.
Personally Known (/ OR Produced Identification Personally Known t-""' OR Produced Identification
Type of Identification Type of Identification
Produced Produced
b fiAAA'
(Signatur of Notary Public-State of FlorideAnn A.Prue (Signature of Notary Public-State of Florida)
Commission No. !001 ass ME
PUBLIC g
TE OF FLORIDA Commission No. ( at I) DeAnn A.Prue
Comm#GG926989 a o NOTARY PUBLIC
�o Expires 1 3 W p
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TU kfte9
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW MVAHM13/2)_%
DATE
RECEIVED
DATE
COMPLETED
ev.
Interior
Notes: D D Y
-All Electrical to be Installed per the National Electrical Code
Existing
NEW 150A Lic# EC1300-5859
MLOPANEL
PM E-ELBCT$ICM&COM
772=46
0 1 m2777
Existing
Meter Existina_ Service Equipment:
Main
Breaker r , - a
7771
Existing
Existing
Voltage Phase Hertz Panel Connections
120/240V 1 60 Wires(A, B,Neutral, Ground)
DATEh �gF $ a PRIDE ELECTRICAL SERVICES' s
*itraer, OF FLORIDA.IIKC
1j,
1 Location Fort Pierce, FLs =�; �a TFf F.7 as> rr
�� J
843 S-Kings Hwy
FLth21DAL Fort Pierce,FL 34945 FAtr]ast-177s
RECEIVED
APR-6 2021
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