HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
- J �7De
.`�Building Permit Application
Planning anvices
8uildinganivisian Commercial Residential2300
Virginrce FL 34982
Phone:(77:(772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: �� Fowl 2SQr ve c
Property Tax ID ft: 3314
- 6 0 1 - DO 61- O c7 0' a Lot No.-4
Site Plan Name:
Block No.
Project Name:
DETAILED DESCRIPTION
OF WORK:
A 1 t,v l Ii u rn
0
New Electrical Meter
Second Electrical Meter
CONSTRUCTION IN
ORMAITION:
Additional work to be pei
formed under this permit -check all that apply:
_Mechanical
Gas Tank _Gas Piping Shutters _WindowsiDoors _Pond
f�Pitch
_Electric _
lumbing _Sprinklers _Generator -' Roof
Total Sq- Ft of Construction:
y 0' f�� �' Sq. Ft. of First Floor:
Cost of Construction: $
;. Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name
Name: ' Q'% VACAOnu
Address: �7a.69
Company: C Q
t State:
Address: fo5 CCU
City:
Cityr\-IJCA.S`Y• t VC{4t State-V41
Zip Code:
Fax:
Phone No. -17.L-
Q -7 S - ]cr 7 �
Zip Code:349uJ Fax:
E-Mail:
Phone No 774-370- 9-1`? O
Fill in fee simple Title Hislider
on next page ( if different
E-Mail --r' (-
State or County License
from the Owner listed
hove)
If value of construction is 2$00 or more, a RECORDED Notice of Commencement is required.
d value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER ENGINEER:I _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
I
FEE SIMPLE TITLE HOLDER: Not Applicable j
BONDING COMPANY: _Not Applicable
1
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Pho e:
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 instillation
has commenced prior to the issuance of a permit.
St. Lucie Count makes no representation
which is in confYict with any
that is granting a permit will authorize the permit holder to build the subject structure
pplicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
ase structure. Pleconsult wi
your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting
in accordance with the appirtived
of this requested permit, I do hereby agree that I will, in all respects, perform the work
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 toyour
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
O
i t
Signature of OWa / "s
Signature of Contracto L' �en Holder
a/Contractor as Agent f r10�
STATE OF FLORIDA
' STATE OF FLORIDA
S6• Gyur.
COUNTY OF
Gu COUNTY OF
sworn to (or affirmed) an
subscribed before meSworn to (or affirmed) and subscribed before me of O
K Ph slcal Presence o
this
_Online Notarizati ec. Physical Presence or online Notarization 3
Y 2020 by his—k&day of �oalr- .2020 by
�nidayof
n,0
�yiName
n
of person making s
atement, 7 ame of person making statement. c:Personally
Known X
OR Produced Identifica ersonally Known 6J- OR Produced IdentificationType
of Identification t
", ype of Identification
Produ d
roducedro(Signature
of Notary Pub
ic- eof Florida } Signature of Notary Public- Stat5odf Florida J
Commission No.�CTyviZ
(Seal) commission Nc. eS�?7�.2fo2 (Seal)
REVIEWS
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r ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
CDUN
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DATE
f
RECEIVED
DATE
COMPLETED
ev.