HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: aLA. off--\ Permit Number:
G
9Uo LUCUE
building Permit Application MAY 2 ,2021
Planning and Development Services Peftii:tln9 D rtment
Building and Code Regulation Division Commercial Residential't. Lu aunty
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
FROPQSED"IIVIPROVEME[ TLOCATION
Address: 603 S. di/f Gma I Xwdo fi 2 a _Flene N o1
Property Tax ID#: 321. ' 1 �"000 I 000 0 Lot No.
Site Plan Name: Block No.
Project Name: Rail
DETAILED DES,C R PTION°,OF WORK:= : .
s e
Amoyt riM OPIAce o I I WS-KAI m dove (11) MA (H or doo a .
New Electrical Meter Second Electrical Meter
CONSTRUCTIQIV fIUFORNiAT1t7IV
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank —Gas Piping _Shutters A Windows/Doors _Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: �1 Sq. Ft. of First Floor:
Cost of Construction: $ Z�o� J Utilities: —Sewer _Septic Building Height:
OWN ER/L-ESSEE CONTRACTOR:
Name.•, RMA Niape:_ . C 17
Address' a."S'.r l Com"pany - i;�
City:.: �:'" State:_ Ad"dressNe
FL
Zip Code: Fax:— w City: State:
Phone No. Zip Code: Fax: j\J14
E-Mail: rka 11 ;(3ylv&e ao1, om Phone No 1 Z —d•1
Fill in fee simple Title Holder on next page (if different E-Mail S d
from the Owner listed above) State or County License Cur 1612t�"w
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.
SUPPLEMENTALGONSTRU�TI0 LIEN LAW iNFC7RMATION.
P
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 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 our Notice of Commencement.
Wii 1VIVA421b, qou M- �/l 26�
Signature of Owner/Lessee/Contra for as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 'Sr�. Lu.c:e. COUNTY OF S-�, Lu.cd-
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization V Physical Presence or Online Notarization
this L5i`1 day of h'N 2020 by this A "day of MA,4 2020 by
Rc'rkt1 M` �otL,nHai �a�nat M oczn
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 Produced
(Signature of Notary Public-Stqtoi jt Flori�q ERINETHORNTON (Signature of Notary Public-Sta Cslprid�j�THERINETHORNTON
ao . ' a o
Commission#GG 942908 Commission#GG 942908
Commission No. q4 `q c� ( .January26,2024 Commission No. cl�Fa�1�# c� ( 6January28,2024
OF tt�P� BardedThru Badpt Notary Saftes �OF�oP Banded Tim Budget Notary SeNkes
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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