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Home My WebLink AboutBuilding Permit Application i All APPLICABLE INFO MUST BE COMPLETED FOR.APPLiCATION TO BE:ACCEPT.EQ Date.:: Pe r mit Nu mbee Bu ding Permit Application Planning and DevelopmentSeivrces Building bnd Code Regulation Drvfsron CQmfnerda[ R2SIC�@tltlai` ' 300 Virginia Avenue,FortPierceh.349.82 Phone .Q7Z)462-1553,Fax (77:2)462=1578; RERMITAPPLiCATION FOR' 0 PU b MPR©1lfMEl1 T`=10CAT n Address.: rDx-i nvi Property Tait I D M . 3'l cl y' — 00 63 Lot' . ' Block No. 4S S. Project Name:;. r�i!rAii is ors R T aNy{'F )t.Qr` ot� eJl_i,��l�nc �+�1cr iAS�CU 11i►J V. C14 C! 111�c�Qr �A,y�e.� New'Electrical Meter Second Electrical Meter CC1.N5TRUCTI�f�INF�RMATffJJ.1[^� # � �h 1h , T< Additional'workto:bep,erformed,;urider.this-permit :check allthat;apply _,Mechanicat. Gas Tank Gas i'ipng Shutfes V1/indows/Doors Pond _Electric Plum hing.: _Sprinklers _Generatork.Roof' a�ta Pitch - To. aCSq Ft of Consfructrort: 1.7� . .. Sq.Ft of First floor: Cost.of Construction $ 1-4 Soy Utilities; .`Sew.:er Septic Building Height .: Q�rN'ERILE�s�Ey � , �„' ,� � -� Y CgNT`RACTQR• � x' �� § , �. Narrae a Cr Qn Name Address: 0?36 S�,n a :V 1 a... �� Co' any.; ci.M} 3Lae(i1S City: 7.AYi4d4ress Zip;Code 3 clQ�3 fax; Ci.tyd.r 5 :. Lain State F�. Phone t.No, S 6 i• �.$I— .56 j 9 Zi Code: P. �,4 R Fax: E-Mall:: Phone No.-1'.11!0. Fill.in fee simple Title Holder on next page(If di#ferent E-iVlaii , e,,N from the Owneriisted above) State or County License_ C.,�.C,�x 3ObS� L.L encement is requlred,e of HAVC is 57500 oc more,a RfiCOHDE�Notice of commencement is equired _ I ft- 110 r*, y I.`3..f.". - '?�`'� t �'S p ,r�.) - v 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: I 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. ,7o?, ' -� Signature of Owner/Les / ntractor as nt for Ow r Signature of Contra / se Holder STATE OF FLORID STATE OF FLORID COUNTY OF U COUNTY OF Guy/e Sworn to(or affirmed)and subscribed before o Z Sworn to(or affirmed)and subscribed befor v _ Physical Presence or Online Not iz ii 9 X Physical Presence or Online Not rtrF; this day f .2020 3 3.2 this_day of ,2020 ya 3 m c< . Im � �. �o rI�Q,.� �iiloru� s s •G,� a�or� 0 Name of person making statement. Z r Name of person making statement, c x D Personally Known OR Produced Iden fi ta Personally Known I<— OR Produced Id tMc ian~ Type of Identification r i 'o• Type of Identification ` o Produced A o o Produced N o � � NNE N N�?• (Signature of Notary Public-State of Flori (Signature of Notary Public-Stat Florida) Commission No. (Seal) Commission No. (Seal) i REVIEWS FRONT ZONING I SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.