HomeMy WebLinkAboutBuilding Permit Application AILAPPLICABLE:1 FO MUST BE COMPLETED FOR-APPLICATION TO BE ACCEPTED
Date: � �'- i``' Permit Number.Building Permit Application
Planning.cnd.,Deve►opnienr Services.
Building and Code Regulation Division. Commercial Residential �
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax.(772)4624578'
PERMIT APPLICATIONF I R:
PROPOSED-1.MPROVEMENT:LOW,ION r��f
Address• 1' 7 5� '_i � �y,! �.c,ur .' 3 �
Property Tax l[)#. Lot No.
Site Plan Name: � ;fir`°
Block No...
Project Name:
DETAILED DESCRIPTICIN OFINORK ,
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New Electrical Meter Second Electrical Meter 1</- T~
CONSTRUCTION.INFORMATION
Additional work to:be performed under this permit—check all that apply.
a°`Mechanical Gas?ank —Gas Piping Shutters Windows/boors Pond
•/Electric... =,'Plumbing _Sprinklers _Generator _RoofPitch
Total Sq. Ft of Construction:. '1"�- Sq.Ft.of First Floor:
Cost of Construction: Utilities: ti`Sew6r _,Septic Building Height:
OWNER LESSEE: =
r
NTRACTOR:
�Y
Name .: ° r '"- ``>;;!' Name:
!.
Address::to '7 2
Company: rr
r
City: r0 `1 State:fj Address.
Zi Code
p r ?• Fax•. State: .
Phone No. Zip Code Fax:
E-Mail:7tu c. #rJ ;=}t- �;• t e'<
Phone No rfr'` i. , �� . .-,•����f
Fill in fee simple Title Holder on next page,(if different E-Mail
from the Owner listed above) 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.Commencement is required".
SUPPLEMENTAL CO:N5TRUCTION LIEN CAW INFORMATION. - n
�.
ER ENGINEER
DESIGN / c Not Applicable MORTGAGE COMPANY: �,P'"Not Appticabie
Name: , ` ._ ., wJr'f,!-�';. Name:
Address: :�;? r`-f�^ �- - � - r F 'Address
City: fY m State. :' Clty: State'.
Zip... •3;��� Phone :.?�,� '�� 3 s� ;'7 Zip: Phone:
FEE SIMPLE TITLE HOLDIER V Not Applicable BONDING COMPANY: ''Not Applicable"
`-Name: Name:
Address._ Address;
City: . City: . -
Zip. Phone: . _._ Zip: Phone:
OWNER]CONTRACTOR AFFIDVIT:Applicationas hereby made to obtain a permit to do the Work and installation as indicated:.
Lcertify that no work or lnOalWion'has commenced prior to the issuance of a permit-
5t Lucie County makes no representation that is granting a permit will authflrize the permit holder.to build the subjectstructure
which is in conflict with any applicable"Home Owners Association rules,bylaws or and covenants"thatmay restrict or prohibit such
structure.Please consult with your Home Owners Association andrev"iewyour deed for any.restrictions which may apply.
InL consideration of thegranting of this requested"permit,is do hereby.
agree that 1 will,in allrespects,perform the wo>k
in accordance with.the approved plans;the Florida Building CodeSL and St Lude CountyAmendments.
The following building permit applications.are exempt from undergoing a full concurrency review:room additions,
accesLL sory structures,:swimming pools;fences,,walls,signs,screewrooms 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 ontheJobsite before the first inspection.. fyou intend to obtain financing,consult
with lender.or art attorne .before sernrnendng work or recordt ng your`Notice of.Commencement:
s t,
Signature of'Owner/lessee%Contractor es-AgentfoeMwner LL ignature of Contractor/Ucense;Hglder
STATE OF FLORIDA, STATE OF FLORIDA
COUNTY OF - C>� ✓ COUNTY OF
Sworn to(or affirmed}..and subscribed before me of Sworn to(or affirmed)and subscribed before me of
��ysical Presence or. Online Notarization. ;Physical Presence or Online,Notarization
this day of & -0 Xl,.W 2020 by this day of 2020 by
Namer of person ma.king'statem nt. Name of person,making.statement.
Personally.Known .OR Produced Identification Personalty Known OR Produced identif catian _
type of Identification Type of identification. "
Pro 'led n. Produced
(Sign,.ature of Nota Public-State-of f.Notary.Public-State of Florida).
r °w SHIRLEYA. 'AONIER
CommissiomNo: 1-1("�CSE�Z r( ,= MYCOMMlSSIOfA4i $io No. (Seal)
r' bV EXPIRES:Janu ry 31,202
'';NQ�r;Y�` Bonded7luuNotai�+ tiGcUndenmists
REVIEWS FRONT ZONING: SUPERVISOR PLANS 'VEGETATION 'SEA TURTLE MANGRQVE
COUNTER 'REVIEW "REVIEW REVIEW REVIEW- REVIEW: REVIEW
DATE.. _
_RECEIVED
PA
TE
COMPLETED
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