HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
ISo
P i ° lb b 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
Address: 151 EI Sito CtPort Saint Lucie, FL 34983
Property Tax ID #: 3419-540-0309-000-0 Lot No.
Site Plan Name: Block No,
Project Name: Hernandez
New Electrical Meter Second Electrical Meter
Additional work to
be performed under
this permit— check
all that apply:
_Mechanical
_ Gas Tank
_ Gas Piping
_Shutters
Electric
_Plumbing
_Sprinklers
_Generator
Total Sq. Ft of Construction: f
Cost of Construction: $ 2 LC 1 �k" C
Sq. Ft. of First Floor:
_Windows/Doors _Pond
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name V>Cly1e\
JCS Kef
Name:
5
Address: 1 I ( )
5 iO C
Company: - QL
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City:
Zip Code: qc\
Phone No.
State: iL
Fax:
1 Ocl orL
Address: DUC�n7 Ut
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City: \ W2
Zip Code:
Phone No
Fax:
State: Ci_
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail
�CY�SfGI Q � fi✓m_
State or County License LC \ dU �22fi
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 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.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
Sw rn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this LAday of�rt 2020 by
Sw rn to (or affirmed) and subscribed before me of
hysical Presence or Online Notarization
this �L\ day of a,y r— 2020 by
Name of person making statement.
Name of person making statement.
Personally Known C�< OR Produced Identification
Personally Known —J.. OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
�NgrfAtu6e of Notary Publ'
Notary Public Stale d Fbntla
Commission No. Ste�i� Kussrath
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OFExpires 11/21/2024
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Commission No.
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER
REVIEW
REVIEW
'REVIEW
REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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