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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I Date: o V�Permit Number:ns-_C_ 3 o L�IC�aL� 0 Ruildine Permit lication �� Permitting aeaa_ment Planning and Development Services St. Lucia Countv Building and Code Regulation Division Commercial Residential ), V 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: PROPOSED IMPRO\/ENLENT,LOCP,TION; Address: �� ©i� t la .h t-Cl1Q, c�� � Q `, P Cep �L QI°6� PropertyTaxlD#: o 43-,2)- nous- moo- Lt Site Plan Name: Project Name: DETAILED DESCRIPTION OF WORK: RECEIVED Lot No. Block No. I (y^S`il&�LL-I�Gr �}' ���_�. r_ �.n - ML-�`lP'}L. 13�cc.o(NCj �N � �'�l`�.�L'is ��1� 1�'tiL'Ty�L►3vi(�Itil, AMe�srvas� Zy w� , A lU` PoaEyq 0�i r-"Off' Copceois Ppo' (� UPI ScjrRrs �xlSl ��+ �oN ��c1t Sif�� S -19-VeX _ I J 0 Lf EC 12iCPA_ A11 7413 Tia., New Electrical Meter Second Electrical Meter CONSTRUCTION INFO.RMAT,ION Additional work to be performed under this permit- check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond _ Llecfric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch 7o`tai-Sq=Ft`of-Constractiorr;CO exets*-'-120 Sq. Ft. of First Floor: &osI o�Cianstrdztis�n r$ ( ovd Utilities! _Sewer --Septic Building Height, DWNER/LES'SEE:' CON;TRATOR: Name IVAN, Name: Address: \;aC)C) Cpal_ Company: City: l_f � Vk P,rC_Q_ State: Address: Zip Code: �ual$9 — Fax: City: State; Phone No. �I `�a w`1(7-�a Zip Code: Fax: Phone No E-Mail: �Mf_©��e�.c615-4� e�vnc�� �C 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,S00 or more, a RECORDED Notice of Commencement is required. S'UPFLI�/I�NTALONSiRUCTI0'UEN [:AUV INFC3RNIAT(C�N r DESIGNER/ENGINEER: _ Not Applicable Name: Address: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: zip:. Phone -.- City: State: Zipf Phone FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: _ Phone: BONDING COMPANY: Not Applicable Name: Address: City: 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. ,V-1k 9Signature::of Owner. Lessee/Contncctor, as Agent for Owner STATE OF FLORIDA COUNTY OF Swgfn to (or affirmed) and subscribed before me of ✓ Physical Presence orl Online. Notarization ih �is � day of 2020 by me'of person making statementU V , Personally Known OR Produced Identification Type of Identifica ion Produce' 1 (Signbttlre of Notar ublic- St KAREN S. NIELSEN Commission No. ,c4,�Y°"g�2 State c($��{ida-Notary Public _. Commissit1n # GG 207484 o; Orly Ct�mmission Expires D . 1) 7n'L2 Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization this day of 12020 by Name of person. making statement. Personally Known OR Produced Identification Type of Identification Produced_ (Signature of Notary Public- State of Florida ) Commission No. (Seal) Ji"Ifilit" REVIEWS FRO NING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 576720