HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� —2 7, Permit Nu m 7a%
RECEIVED4
O
90MBuilding Permit Application APR 212021
Planning and Development Services Permitting Department
Building and Code Regulation Division Commercial Res2brftLXie Ca nty, I=L
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: IVI�,,� gujl�i�9 �a.ca
PROPOSED' IMPROVEMENT LOCATION:
Address: ' e1W ocoyP.fS to&6 F4. PL;cce
Property Tax lD#: )_ 1 .� oOV10004Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Zn n c., C4 , X S
In9 fi a K) C if o e �z
New Electrical Meter �Jo Second Electrical Mete l Jo
CONSTRUCTION' I NFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 350 Sq. Ft. of First Floor: 1.Wo
Cost of Construction: $ ad, 000 Utililties: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 3uNer. �
Name:
Address: ` 01j iO Coc uerS RQCXt
City: F+. pie -re ,
Zip Code: 349g1 Fax:
Phone No. Nn& —'Mo "«q5
E-Mail: b
State: IFL
'Ll CAM
Company:
Address:
City: State:
Zip Code: Fax:
Phone No
Fill in fee simple Title Holder on ndxt
from the Owner listed above)
page if different
E-Mail
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Co mencement is required.
SUPPLEMENTAL CONSTRU'CTI`ON [EN LAW ,INFORMATION:
DESIGNER N I EER: NQt Applicable
Nie: �e U-0
I
MORTGAGE COMPANY: Not Applicable
Name:
Address:11A
Address:
City: State:
Zip: Phone:
City: State$
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 pE
which is in conflict with any applicable Home Owners Associa.
structure. Please consult with your Home Owners Association
In consideration of the granting of this requested permit, I do
in accordance with the approved plans, the Florida Building C,
will authorize the permit holder to build the subject structure
ules, bylaws or and covenants that may restrict or prohibit such
review your deed for any restrictions which may apply.
by agree that I will, in all respects, perform the work
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.
i ; atyrnfowner/, Lessee/Contractor as Agent for Owner
l5-rs
Signature of Contractor/License Holder
STATE OF FLORIN.
STATE OF FLORIDA
COUNTY OFCOUNTY
OF
Swor o (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
this � day of 2.GM by —2
(IzmP
this day of 2020 by
S iie&yn
N.Wme of person making statement.
Name of person making statement.
V
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature No
(Signature of Notary Public- State of Florida )
AUDREYS.HU PHREY
Commission No. :*: :*2 WOOMMISSQ;� a 17
Commission No. (Seal)
`' RES:111169aar , 20
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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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