HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
2CTo L1C2
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U IL ° ° ° p 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: E-'L-t, •G L
,PROPOSED IMPROVEMENT LOCATION:
Address: I q 1570 �ff SP OC.1--enr►.Tf; 2 e-.--
Property Tax ID#:_ _7 31 -1 '417. CG b ® ® O 0 Q S Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
4n0M4:!*Z QzZ 4,-�2
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
�ectric —Plumbing —Sprinklers —Generator —Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name o V e 2IL5. Name: r`T H
Address: qoN 05CCola lQ 4' Company: Tt . J rn r rt-, V L'ec,:'r`L-AL .Sen/
City r� + F(e r C e JZ 114 State:_ Address: O'7 �9-1c�_ Lf3 Y..e a k r`
Zip Code: �Zt�C77 Fax: City: ��rT �:•e rc_� State:-F--L
Phone No._ 7 .2. 2qO 361, * Zip Code: 3y A I Fax:
E-Mail: y, ` ovr►Q(`r�nS�r �_�)��EdnrJ Phone No J 6 f- g Z--�117
Fill in fee simple Title Holder on next page(if different E-Mail �-,9r% ,T� SP.r✓1 C-aS Ob- GoyL1`l. -c
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: 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 magestrict 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 our Notice of ommencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORID
COUNTY OF COUNTY OF f5f .I u co
Sworn to(or affirmed) and subscribed before me of Sworn to(or-affirmed) and subscribed before me of
Physical Presence or Online Notarization Ey
l Presence or Online Notarization
this day of 2020 by this IX�1 of 202¢ by
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
Produced Pro ced
J't Y' -) ea Ld
(Signature of Notary Public-State of Florida ) (Si nature of Notary ublic-State of FI rida )
;:�'pva�e::. KIM(1190
Commission No. (Seal) Commission No. otarv;)uoiic-StatteofFiorida
�� 'c` COmmissior;44 037409
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B rced throi.nh Naticra:Pion a� r
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETA OVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20