HomeMy WebLinkAboutBuilding Permit Application All APPLICA LE le IFO MUST BE COMPLETED FOR APPLICATION TO-BE ACCEPTED
Date: Permit Number: cCJ `1' 0
RECEIVED
No 3 0 2020
Building Permit Application
pepa�P
Planning and Development Services I�erltt� 9 e Countvent
I Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)46271553 Fax: (772j 462-1578
PERMIT APPLICATION FOR:
���, T
,.....+.n...4.,�,.v_.a�...«:, :�t.�,.a.�-a�.ay..rr...N...�.r_. .a.:.•., ,.. . r ..uw,n.K>.....:....-4.. ._�r.�-«,. �, ...: . Cr.�,.?.'.�5.:?'-".r.-,_ fi,.:m�.r-,'�'_x,- "a..zt c.�.�u,.Wzt+.�336i;�r2.ta...,5.. l§, '�g' 'Address: SSPP�-
' f I -T
Property Tax ID#: Z31� � ,,��^^(�7���1/'�Q��`�t Qm `? � Lot No.
Site Plan Name: � '� FAQ Block No.
I
Project Name:
1
-y.� � ...ua. � F. :-, �- •y � ,� . a r' 7. �;,:.,.�+c,,,,,„ „� ro stt �C'#ksw"l �e. �.
�� ���Q vHj����1 � �{` .. �#•�.} `+� ;{�,� •at r�'`�� 1��r ty., ��M ,�I et' }�"`,��,;�.�:, 'i��"st a+- r''-n.'.
.x..,.,.uf .....a.2`r.�u+h_ _,..c...:.... ....... �x ''�.:� k, s.,7 c.t:r:._.s.. .��.ar..x... ..�'4. �'r�'����z�.:�i .� ,�v'S.., }`.sew'.r�'C.v`�.y '!»:;•: «'�.3:�c..
� I
New electrical Meter Second Electrical Meter I .
r��. - .."r- 4fyn ,"`'d3 y! .- x"'„SI it irr.,ip``rta'I::�-�-,�,. }. 1 ".�it'F"3�iy _^;>.�•,;}s y,•�sa` -c ,�'�,( i".a;'.,, xz-t:4
�.. '���Y�� f j
Y r,tY Z
y4�"r��y"F�#✓ t�T�'�'�3'�1�k" �€�rJ4�� 1=�Y��'�, "puat �
,. r.:u,.,S_.-.,m.^n�^•S!.bv.'?.i-.s,iK,.ra..L�zt max.,-.=.sr N-.-.<:}.s."� r.+,r..,.�.�v�'".:.�k:�L-�.:���,is .�..#?�t..r.. +,.:x>_y r ,:.0..._�x_.•,+3n�c:� :.};YS`'�'.3`�a'�.. H..;,n.: e.3e'�..,.`.�..'cet..,....:.al.�
Additional work tb be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters, _Wind Iows/Doors _Pond
_Electric _Plumbing Sprinklers _Generator _i oof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ Utilities: —Sewer '_Septic Building Height:
..., .•,- -..,, _ ttv< r t < r L 1�
C Lj, ` qs r 1
4N � f LSSE rl F 4� O < d l z t 4 �t5aR1�1 \F r h i a 3 r 2 T k
..,. *e., "x ,c:u `7... •.. 3 C t. 7 ;...�. Y "i ...._.?'°+F:u- _ _ E5" ?..�_.'�S r J._., =f,# �'.,x.t... 1`".!T•.: C'.c;
_ ..
Name~ ���,,fcccR Ukm Name: ,,_ 1
Address: q5Q an�1 rw..� _ _ Company:Al- EN� 2 mPtil tl�
City: F , State:F i - Addresss:16S-5W Jrjh)(i TE91
Zip Code: ?,�`� � Fax: City:'�7)�-314,50
jam' �JC I Stater
Phone No.1fl,3WOO)Lit- Zip Code: 314, 0 1 Fax:
E-Mail: Phone No dd ( 3 QI' 11
Fill in fee simple Title Holder on next page (if different E-Mail :]?? 201 9`f2 `3
from-the Owner listed above) State or County License
i
i
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.
I
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 fulfconcurrency 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 recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder .
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF_ �/�;( Lo U COUNTY OF . Sa.A
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presen or nline Notarization L-- f y- 'cal Pres nce or Online Notarization
thi cd: y of 20� by thi ay of 203 b
P V1S rw--�
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification L'' Personally Known OR Produced Identification
Type of Identifi tion Type of Identification +Produ d L Produced D L_
RRD
(Sig atur No a ub i - a omidar Public;State of Florida ° ',r�a}y Public,State of Florida
) AMA=16817)
(Sig ture of N li- o?w I r
Commission#GG 206912 Commission#GG 206912
Commission No Mb�ll) expiresApr..16,2022
Commission No M} )expires Apr.16,2022
REVIEWS FRONT ZONING. SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.5/6/20