HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
gam. LUCEL!,
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:
I PROPOSED IMPROVEMENT LOCATION: U I
Address: 3L) cj N. I lac F ZSU:--:) V*-, yi f' Y Cj—, `I
Property Tax ID#: L4 Li- (nLot No.
Site Plan Name
Project Name:
DETAILED DESCRIPTION OF WORK: Cvy ercP.rlclJi AC (�1Y �t �� nth
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Ctk : ri110 3b (-t (4) kemA COD b 34
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical
Electric
Gas Tank
Plumbing
Total Sq. Ft of Construction: k25 k
Cost of Construction: $ `y;t cc)
Gas Piping
_ Sprinklers
Shutters _ Windows/Doors _ Pond
_ Generator
Sq. Ft. of First Floor:
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWN R/L SEE:
CONTRACTOR:
Name \ I
Name: q M Y ✓ie
Address: , N� zNC
Company:
City: qCk State:
Zip Code: �j�ri�t—� t lFa& �C
Phone No. 6LOO Oi
Address: O rj -
City: �( � _ State.
Zip Code: —2341 4:�__ Fax:
Phone No kk'Lt3 �1
E-Mail C -
State or C unty License
E-Mail:_
Fill in fee simNje i cue polder on next page ( if different
from the Owner listed above)
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 LAW INFORMATION:
if
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY: _Not Applicable
Name:
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 receding Your Notice of Commencement.
" '**V 4�� ---
Signature of ner ssee/Contractor Agent for Owner
Signature of Contractor/License Holder
STATE OF FjAA
R�D
STATE OF FLQRjD � A
COUNTY OF 1
I GQi(lr� �n�
�
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Physical Presence or _ Online Notarization
S orn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 2020 by
this _,, day 2020 by
A_
kkQ`root ' S`3C.1 1
l ,o'f ` I
1 arX ' �V 1 • e5
Name of person making statement.
Name of person making statement.
Personally Known —1s,_ OR Produced Identification
Personally Known 4— OR Produced Identification
Won of Identification
Typ f Identification
ro uced —
Pr9doced 1 Y
Signature of Notary Pu c o ghridaili State of Ronde
(Signature of Notary Pu col, fX 11C st of Fr
? Analisa Whiting
itin9
Commission NO. my Cqq��pm{i{��ion GG 339912
ExpvA�Ii3 12023
E' Y �sion GG 339,
Commission No. '? tl' Expues( '�023
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ttev. 5/b/20