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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COM1=ri:X--- ED FOR APPLICATION TO BE ACCEPTED Date: a Permit Number: Q \,d OAR RECEIVED c3 Building Permit Application BAN 0 71010 Planning and Development Services Permitting DepaKment Building and Code Regulation Division Commercial Residential St.0 ' ounty 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: PR'i)POSE 11l11PRQ1/ WNT `QC "T 'A dYvt Address: 72,6 f-t-),e­�r el tic/, Property Tax ID #: Lot No. Site Plan Name: Tn'�( Block No. Project Name: �LJ� ,yaDf' X-efoV-�-S m A.yr0-/- .gel-Aler New Electrical Meter Second Electrical Meter Additional work to be performed under this permit- check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond t.'/Electric plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: -57Y Sq. Ft. of First Floor: S- J�- Cost of Construction: $Z!5� 2ST' Utilities: ' Sewer _Septic Building Height: Name Y�z _u/ems LdI&X2 irc, n Address: �,,2 �c Al -le 114"o - City: (��zs.e.z 1.� -�4 State: Zip Code: Fax: Phone No. r�o ` 1' 1 03 f E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: /-5On4.lCL L 0/c-e/r Company:WMAer POc ".q eotq&'�e- Address: 7Z,99" City: P/-cr cV. State:l 1. Zip Code: 3y,7S Fax: Phone No ?72, E-Mal r�©r�rrycob,��Clio�url Ab State or County License-S24,k< /13 7 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 requi � 0 o 3 3CD rn- O O X tV � 'SUPPLEMENTALCONSTRUCTIGN UEN;LAW INFORIVIATI�N DESIGNER/ENGINEER: _ Not Applicable f MORTGAGE COMPANY. Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLEHOLDER: _ Not Applicable BONDING COMPANY: Applicable Name: _Not 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 noywork or installation has commenced prior to the issuance of a permit. St. is in conflict with anrepresentation applicable' Hothat thto e Owners Associiationirules,bylaws or may restrictbor subject and covenants at 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 Florida plans, the 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 intend you to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. Signature Owner Lessee /C ractor as Agent for Owner Signature of Contractor/License Holder STATE OF kAiOniG�*C� STATE OF FLORID COUNTY OF xc rmb COUNTY OF '• vtx.� 2 I Sw rn to (or affirmed) and subscribed before me of Physical Prese c or Online Notarization S or o (or affirmed) and subscribed before me of M ical Prese� X. this d�aay of 2020 by c^e o-r- Online Notarization this �y --LCLA of 1 202d by H \' ;Ll O � IGut NN Name of, person makingstatement. `= Name of person making st ment. c o Personally Known of Id�tificatOR Produced Identification � Type Jgion N Personally Known OR Produced Identification Produced llCt�i�� ��-e�(`fjj� r, _ Type of identification Produced (S ._ature`c,f, ar ublic- State of Florida (ignature of Notary Public- State of Florida) Commission No. N IA (Seal) Commission No. (Seal) REVIEWS FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEA TURTLE MANGROVE DATE REVIEW REVIEW RECEIVED DATE . COMPLETED ev. 5/6/20