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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE Date: LUCE Li 'i:ED FOR APPLICATION TO BE ACCEI- i to �b Permit Number: �7Ga&' 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 APPLKATWN EOR: RECEIVED R 14 1011 Residential pormittirg Department St. Lucie County PROPOSED II1P,ROVEMENT LOCATI;ON...,. r I I Address - mi-N u; i I i_u P,.q,(`-P La,-) P. . P 3-�6 Property Tax ID #:s- - Rol, - (off ? ' DO "a Lot No. Site Plan Name: A e'ry Ac' t S Block No. 3 Project Name: Cl''1.0i1 i-C'L1r1 C'L New Electrical Meter ✓ Second Electrical Meter wr CONSTRUCTION INFORMATION Additional work to be performed under this permit- check all that apply: `Mechanical V/GaS Tank ,/Gas Piping ✓Shutters _Windows/Doors _ Pond VE'lectric -Yflumbing _ Sprinklers _ Generator _✓Roof iv / oL Pitch Total Sq. Ft of Construction: Iya C I Sq. Ft. of First Floor: �� a Cost of Construction: $ a $S- 000 �, 00 Utilities: _Sewer Vseptic Building Height: % Or sI pGk. OWNER%LESSEE `, x 1 , u i CONTRACl'OR Name-rhDIY od 1i LGi,/ofA Name:_R�,-1 A LCtl-n Company: KPI U %NA/114.-A ar— Address: TV) &(A) 0'tW CCis`H-e City: 24- 3+- rW.I —,P_ State: JC-L Zip Code: 3 Y q X 0 Fax: Phone No. 6 30 - 361 (O - QSJ 3 Address:Sqathw 0ermi-We Pliaey City: P - S4—► AA tl Zip Code: NO& Phone No State: (-� Fax: E-Mail:-Lrvn30W©GIIY►GUI , Gi7r>1 Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail 00-S; , C r)A4-n tC4-I?Vpn State or County License (✓C)C 0(�Q& 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. t SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNEit/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable Name: �x� l �A _ /% Name: 66 -7 Address: t C Address: 1/J0 City: fiS�- `t? Stat�- Zip: City:��„ 1�P e: PL ' Phone i Zip: �a 1 la Phone: Cl 0 - 3(0 / - S i I q FEE SIMP� E TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: f Address: City: City: Zip: € Phone: Zip: Phone: OWNER/ Q NTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that r�o work or installation has commenced prior to the issuance of a permit. St. Lucie Countyy makes no representation that is granting a'permit will authorize the permit holder to build the subject structure which is in co�i' ict with any applicable Home Owners Association rules, bylaws or and that covenants 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 accordanc f with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The followingibuilding permit applications are exempt from undergoing a full concurrency review: room auditions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING, rO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for improw'!ments 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. i Signa re of`Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF jFLORIDA STATE OF FLORIDA COUNTY CIF_ IST L GLA- L5 COUNTY OF Si C.(/i C I L' Sworn to (or ✓ Physicz affirmed) and subscribed before me of l Presence Online Swo?r to (or affirmed) and'subscribed before me of this�lq� dark or Notarization of t1'1QJfilt ,ire by (/ JP �ysical Presence or Online Notarization this • 7�- day of nD(RQhz,h2.r 2020 by 2azl Name of person making statement. Name of person making statement. i, Personally K�iown \��1111111111f1/////� OR Produced1rd1 0 "�i Personally Known ✓ OR Produced I� ��RONs Type of Identtification Produced k `�`` ; •wk� I�-C L 12,20zO ��v��'��;•. Type of Identification ,ION �' Produced t2, v��a;•. • 979919 (Sig ture cif Notary Public- State of 0 ' ' o40:•qr a ���'` Si n t re of Notary Public- State of FI ( g y .� d o �'Ay'?,'Doblidc Commission!No. ubBe Uad�'� C C\ Q7gq q +.•... oF����` /� Commission No. C)CI q-1M q REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE r COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE ` RECEIVED DATE COMPLETED ev. f ti :