HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE,ACCEPTED Date: Id -dl' JNO Permit Number: o�l�oi • 0g?�
ST. LC.ICIE
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED 'I.MPROVEMENT LOCATION.
Residential
Address: S'iq %ea.cA• Ave pSl. � FL 3g95;-
PropertyTax ID #: 3469 ` 510-ea3"I -000-1 Lot No. S, (o
Site Plan,Name: SAIISpa Block No. M
Project Name: W I[Salt) IFaOL.
DETAILED DESCRIPTION OF WORK:
A&W SWIWA1144% penl_ 6046-Cltuc1I014
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
I Electric _ Plumbing _ Sprinklers _ Generator T Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 33,Sab. Go Utilities: —Sewer _Septic Building Height:
OWN ER/LESSEE: ,
CONTRACTOR:
Name bA %Xd-&% W 15fl►J
Name:C+2u ST s4. WASABy*d l
Company:Ae..a pool&
Address: 554 13SAc,* AJ-
City: P SL State: FL
Address$3?6 901"" C7_
City. ��I&MACA Stater
Zip Code: 3495a Fax:
Phone No.
Zip Code: &2gj21 Fax:
E-Mail:
Phone No -)79. - 58y' 755kl
Fill in fee simple Title Holder on next page ( if different
E-MailC kk!n/ S•-e, l to 310Sn^a.�
from the Owner listed above)
State or County License 2Pdsa s5$ 41.b
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: E-L- S W&C-A4Ao4
_
Name:
Address:
Address: W 9 M40,11A — A-
City: koft 7, tte
Zip: Usila Phone
State: _
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY: _ of 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 your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature.oT Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Si. L%4c.Zcr
COUNTY OF 64. G, -GC-
Swo,rn to (or affirmed) and subscribed before me of
Swo r to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
this day of P&lw6sr 2020 by
this -zl of P&iMb0 2020 by
yu� W � �5ar
nday_
. I
�"X 5•�.I WGS�brt�n
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
ProducedD,..`v�1t G,�t a aSL
Produced Dr-ZjtCCS Ucgda
(Signature of No S N t uo
(Signatu o N - o j(jjr
r' 6� ••
�� State of Florida
I x3 wwo� 6W
6ZOZ 4 A¢W say d
Commission No. uolsslwwo3(SeajCommission
;=o�;R Notary Public
No. mmission N s
2024LL"N
ePNoid {o a3e3S • �Ilgnd bnON :b�Rl�wxl
Valy ' -
''� MCre���
d through National Notary Assn.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6/20