HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE-CO�^:. 1_ETED FOR APPLICATION TO BE ACCEPTE''L.-- .,
Dates � _A .3. Permit Number:
S�
ST. LUCIE
CO U I NT�Y
F L O R I'" D A
Building Permit
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 APPLICATION FOR:
J ,PROPOSED IM'PROVEM'ENT `LOCATION:
Address:
Property Tax ID #:
Site Plan Name:
Project Name:
DETAILED DESCRPPTION OF WORK:
New Electrical Meter >'-, Second Electrical Meter
CONSTRUCTION INFORMATION:
Additin.nal work to be performed
/Mechanical Gas Tank
v Electric vPlumbing
RECE-JV9
Applicatio MAR 0 3 2020
1. ST. Lucie County., rmitting
Re
under this permit - check all that apply:
Gas Piping
_Sprinklers
_ Shutters
Generator
Lot No. Zd
Block No. q 6
"Windows/Doors _ Pond
V"Roof 6 /12. Pitch
Total Sq. Ft of Construction: 17 7 FT Sq. Ft. of First Floor -
Cost of Construction: $ V97LI. �" Utilities: —Sewer Septic Building Height 11 3
I OWNER/LESSEE:
CONTRACTOR: .
NameYj01X2,1 -t%V"' Cn '(b1CLna0rd
Name: lcaxlL--ral�5r
Address:l 0l0 5u_nS-'� CDye ciy.
Company: -�.
CitState:
Zip Code:3':b$ Fax: NJ Pk p,
Phone No (n3) 1—J�97
Address: 2�j� S(.J i�S�-��VG►
City: ?cv'v S-fils-i-C 1`1'� Stater
Zip Code: �}913Y Fax: IV/ 1�
Phone No b-1 c02(o �311(0
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mai T!5y_ r1E04 % d r4 0W G0-0n
State or County License C j3 C 1 z 6 30 7 �.
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 CO`NSTRUCTfON'LLE;N' LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: L11 C �/` � 1'�n 9 rn e!m
Name:
Address:
Address:
City: rcr' z State: tiG.
Zip: Phone]71_- 1-2 1-- S q f It
City: State:
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 d p sted on the jobsite before the first inspection. If you intend to obtain fi ncing, consult
with lender a ttorne ore mmencin work or recordin our Ice f Comm ement.
Signat a ofOwner/ Le-/ee/Contfactor as Agent for Owner
Signatur f Contra ctor/Lic e Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF_J' r . I A,u -C,
COUNTY OF 5T - CA e
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this i—'t►-clay of Feb 2024 by
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
this jZ day of I(—c lia 2020 by
IMAv'1g;_
MN K
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produceld�
Personally Known X OR Produced Identification
Type of Identification
Produced
VJ
(Signs re of Notary Pu ic- State of
var Notary Public state
i Robin L Bowen
Commission No. �QS 1,1 a My CommissionGG
a w Expires 0210412023
I n re of Notary Pu lic- State F o i a
Flori
r a Nppb�ary Public State of Floi
9:nimmi ion No.G6 % �dbinLBowen
My Commission GG 298212
q R� Expires 02/04/2023
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 5/15/20