HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ^� q
Date: 2 2 Permit Numbert�,
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x ° 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
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
-Address:_-r�"l I ) Ea6-1- O'� �)gyve- R-z Pipe , FI, 3Li 51
PropertyTax ID#: 1301 613 0041 000 ? Lot No. �
Site Plan Name: Block No. 13�
Project Name:
DETAILED DESCRIPTION OF WORK:
7 o
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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: Sq. Ft. of First Floor:
Cost of Construction: $ 2.r 44 r]s 00 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name &er2.oL Sl!i&r- Name: A 'i f
Address: S71 1 rC -E-r,)voJJ Drtl/e. Company: bJ f (7e rl ems/ C'oa1
City: F*-: Pif/'C.e State: FL Address: 331 me.r�(� venues
Zip Code: 3q9 S 1 Fax: City: F�-- Pdncp- State: FG
Phone No. C 7720 SCSI- /.335 Zip Code: 3L-f4 tJ157 Fax:
E-Mail: Phone No--I 1 Z- 2 16 - L-1 9? J9
Fill in fee simple Title Holder on next page(if different E-MailP o��p A 6vap 1'
from the Owner listed above) State or County License Gc j51-11 Sgs
L-fvae of construction is 2500 or more,a RECORDED Notice of Commencement is required.
e of HAVC is$7,500 or more,,a RECORDED Notice of Commencement is required.
Ps-v X -]O DtbL- j I 100'3d L6T al i3�'
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 recordin ur Notice f Commencement.
Signat f /L s /Contractor as Agent for Owner Sign re of tra /Lic se Holder
STATE FLCIR STATE F ORID
COUNTY OF - Lu cce. COLIN F �7 )—tic-td;
Swgrn to(or affirmed)and subscribed before me of Swor o(or affirmed)and subscribed before me of
Y- Physical Presence or Online Notarization Physical Prese ce or Online Notarization
this lam'day of ,g use— ,2020 by this / "day of 202# by
,bWc,.L4v1C Ph;//1'4s �r�lr. «e �h�l1►',�s
Name of person making statement. Name of person making statement.
Personally Known_ OR Produced Identification Personally Known L'_."_OR Produced Identification
Type of Identification Type of Identification
Produced Produced
JENNIFER SMITH JENNIFER SMI
(Signature of I Jotary§ - rida) (Signature of N 3tary PS�1�>FPI.®q{da)
NO.HH7484 i —' NO.HHV464
Commission N)MYCOMMI"IGN EXPIRES JUN.94$9 '); Commissi W00MMISSIPNEWF6
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6/20