HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPT D
Date: �� as an ��6� Permit Number: -0 5
91ff.
O RECENED
> p ! Building Permit Application DEC '2 2 20?0
Planning and Development Services
PgCrnikkln9 Department
Building and Code Regulation Division Commercial Reside ni1F�d I.ue►n county
2300 Virginia Avenue, Fort Pierce FL 349821
Phone: (772) 462-1553 Fax: (772) 46271578
241JUTM-11M'1141-1v �\ •C
P;R,OP..OSIE tD, IMPROVEMENT;LOCATION.
`}
Address: 4 ZO k S+. L.uci,ee RIid
Property Tax I D #: I q31- 111- 002 0 00 D - y Lot No.
Site Plan Name: Block No.
M
Project Name: � - I C Ciee (A/o-ye6usip-
ESCRIPTION OF�WORK
build 0U+ 6f WirnrylorcirJeh0L6e NO
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 X Plumbing _Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ cZQ i OOO Utilities: —Sewer —Septic Building Height:
OWNER/LESSf E
CONTRACTOR:
Name IHP1� i+ Lucie, Nyd LLC
Name: Chris McDavlrie-ll
Address: d &7S 9 dlrocksmi-(-I„ 201
Company: CI)hcord 9046(ing
1 )r10-
city: 1 -� Ney-ce State: A,
Address:142 NW V(eaxan+ P
yDVe i/✓aN
Zip Code: 2 4 94 S Fax:
City:y"by+ 54. coc i e
State:B(1-2
Phone No. 1 2 " 370- L04 /
Zip Code: 3q-98(0 Fax: -)21
-(oZ 1-) 8 31
E-Mail: PI e,(An1s ruh-ftree C@ ho4matII- Cdvh
Phone No 33(o -Sq'066
Fill in fee simple Title Holder on next page ( if different
E-Mail ` C6?7COro(JA i(di va C�Y 6
@ Gmai 1. com
from the Owner listed above)
State or County LicenseCSGl39d02(o
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 IAW INFORMATION -
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY•- ,e,Not Applicable
Name: _ , ,
Address:
Name:
Address:
City: State: I
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'commencing work or recording our Notice of Commencement.
Signature o wner/ Lessee/Contractor as Agent for Owner
Signature elon—tractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF arLucis
COUNTY OF SiLvcia
Sw rn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
A'_ Physical Presence or Online Notarization
this 22- day of UecEMl. u 2020 by
this 22. day of iecVftae . 2020 by
CNRIS r CPgtINed
( 21s Mca0rJN8c`
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known C/— OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
ALAN A®AM
(Signature of Notary Public- %q of Florida -Notary P
•_ commission N GG 2330
bl nature of Notary Public- '� ► tp)of Florida -Notary
0 •= Commission M GG 23981
+ `� My Commission Expir
Commission No. C,423361� '� �M0 (Seal) June 28, 2022
.
s % �= Q�mmission Expir®§
My
C mission No. 4a7zm 9 '••. �Nd:�`� aCne 28, 2022
REVIEWS
FRONT
ZONING'
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20