HomeMy WebLinkAboutBuilding Permit Application PacketAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
VLL0@11ELD11 All _ 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 IMPROVEMENT LOCATION:
Address: i_)C- ncC
Property Tax 1D #: Li IA I- SO?- (DO I 1000 ' Lot No.�
Site Plan Name: �V S� 1AAC� -C LOT —1 �.® LAC I i`z2M Block No.
Project Name:
DETAILED DESCRIPTION OF WORK: I
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 _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 194 2LD
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Q Iff
Name:1.
't I
Address: m u r_�' emX �x nd
Company: or
� u YYl1 i y)
City: VOY 1 Sk LU O-C W)CkV 4 State:et
Zip Code:3LA 0� e Fax:
r�\2 VtrJA-_,�2
Phone No. yo L3.,
Address:
City: . � • i 4 (.i
Zip Code:
Phone No
IV_e .aV_ _
State
Fax:
., .,... --
E-Mail:_6.1ff" (0 ItO1 • GOM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail •SID LGs a Will
) ll_)al l(D_jE
U-Cl.
State or County License
`a
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:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:irk r i 4 a'
Name:
Address: !:jkVITI,Cti T�-Cx e3>��D1
Address:
City:-VOY-- cty-hy %0it'c. State: 1r,--
City: State:
Zp:3 :Jq5?_ Phone ?tom, Ste: '163!3
Zip: Phone:
FEE SIMPLE TITLE HOLDER: e/ 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 Horne 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 l do hereby agree that 1 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 corded in the public records of St.
before first inspection. If to obtain financing, consult
Lucie County and posted on the Jobsite the youintend
with lender or an attorney before commencing work or recording ou Notice of Commencement._
a
' ature of ntrattor/License Holder
ign Lure of d5vvner/ Lesse / ontractor as AgKmtfor owner
STATE OF FLO
STATE OF FLOP DA
.
COUNTY' Of rk,
COUNTY OF�A - LA Et
Sworn to (or affirmed) and subscribed before me of
swgrn to (or affirmed) and subscribed before me of
V Physical Presence or Online Notarization
J Physical Presence or Online Notarization
this 24 day of 202t by
this day of , 2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Icin (cation VI/
Personally Known OR Produced Identification J
Type ofIdentificationJ �° AS7p ir,�
Type of entlfirationa�E?�, f
'S-"
Produced
fgnature o Public- Stan': of,Floridpa
ature of ry P b - state 6J ftc ida
GG4535�
Commission No. _�9eal
�
Commission No. d >alj
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATC
RECEIVED
DATE
I
COMPLETED
l
Rev.