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HomeMy WebLinkAboutBuilding Permit Application'TV _40IMML VW All APPLICABLE INFO MUST BE COMPLETED FOR A �.ATION TO BE ACCEPTED Date: Permit Number:.,--,?) 19 RECEIVED APR 2 7 1021 Building Permit Application P�coon'rm;ttis9 D��artment Si, Lucie 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 PERMIT APPLICATION FOR: PROPUSED INIPftt7UEMVNIN LUCA 1f3nnN: Address: � � 1'T �� 'T. Loc, ri''d rv2 Property Tax ID #: ? -1 '� 1 '� �� 0 ^ 00 JCJ - Lot No.�� Site Plan Name: Block No. Project Name: DET 1LED ► E�SCR�FPTIO OF Wi3RK: P E2 re-.e New Electrical Meter Second Electrical Meter O0 f NON IQMIN�dR 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: 2-- f o Sq. Ft: of First Floor: ©DD Utilities: _ Sewer _ Septic Building Height: Cost of Construction: $ ,,4foe UWNER I] NOS; CUMUM ACTUR• Name y-eJ Address: � 1' cocoof'A 1-t Ve-• E Comp'any:. City: Or ✓ ciState: ��- Zip Code: ?29 �! S- 2 Fax: Addesss..: :,,:� ," i..,, t,c'. +f ILI City: ,"" " State: Phone No. 7 7d2 - I Zip Code: Fax: E-Mail: % hone No Fill in fee simple Title 1401der on next page (i different E-Mail State or County License from the Owner listed above) 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. DESIGNER/ENGINEER: Not Applicable I MORTGAGE COMPANY: _ Not Applicable Name:_ Address: City: Zip: Phone FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone:_ State: Not Applicable Name:_ Address: City: Zip: State: 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 attornev before commencing work or recording vour Notice of Commencement. Whature �oflbwn&f Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORID STATE OF FLORIDA COUNTY OF COUNTY 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 thi4Z day of 2426'6y / this day of 12020 by Name of per on making statement. Name of person making statement. Personally K OR Produced Identificatioe/ Personally Known OR Produced Identification Type of Identiacatlbn Type of Identification Produc 01 r `„ Produced (Signature of No P a,e o �9 ' ZHUMP (Signature of Notary Public- State of Florida ) •''' '+.t MY COMMISSION # GG 3p081T Commission No. `*i :c EMBE%p rch6.20�3 '00-f0g.- pumicUndc�wdtws Commission No. (Seal) 60010dnluNoraty REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE —' RECEIVED DATE COMPLETED Rev. 5/6/20 , ` I