HomeMy WebLinkAboutBulding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
'.'. CUCER
L Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: (7- r—or+ W4 40r\ v F-L P&L.Le E 't
Property Tax ID#: 1301=652 -U-23 1 -000 -2 Lot No.
Site Plan Name: Block No.
Project Name:
i DETAILED DESCRIPTION OF WORK:
t►S-iCc ��na - -ZZ x26 X V Me+a 10_rpg -J o_n$,neefiea c.,-.d bu. IL bw
5C14to.TS. 6nr9oF4 wk If 6e +.-154Ilvrl v,'k Px15� A nnC(P- + n Il•fb-;
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 Hoof Pitch
ion: Sq. Ft. of First Floor:
Cost of Construction: $ 2q QQ Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name:
Address: 2 SG Wa 1 IvYI f} Company:
City: Farr Pte_r(e_ State: FL Address:
Zip Code: Fax: City: State:
Phone No._ 56(-3 I �� LJ _ Zip Code: Fax:
E-Maif. Aor-)-oncA. r M CO orrnA Co&-A Phone No
Fill In fee simple Title Holder on next page(If different E-Mail
from the Owner listed above) State or County License
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: Name:
Address_ Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable
Name: dame:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFEIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated,
I certify that no vrurt or installation has cornni enced 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 folk3wing budding permit agpiiitabons 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 job-site 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.
I
Signature of Own /Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
1
COUNTY OF a , 'I)CA-c COUNTY OF
Swor o(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this day of MC6� 202J by this day of 2020 by
Name of person aldng statement- Name of person making statement.
Personally Known OR Produced identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Pr ced Produced
VL—,TIt-Mk
(Signature of Notary Public-S t+3of prida} LORI wil uAMS Signature of Notary Public-State of Florida )
i Notary Public•State of Florid
Co mission No. ( mission p HH 116443
orn,. 1�IPg .rr,,Expires May 202 ommission No. (Seal)
Banded through National Notary A55
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
CbUNTFR REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED I IFF",
+�P'a; NEA HER
ey, _ 4 orid2-Notary Public
'= Commission p GG 18321 7
S !3 Z/ D�, ° �.�'P�' �Y commission Expires
��" February