HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPUCABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n
Date:. 1-1-s% Permit Number:a I Q l' 035
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' ` ° `�� 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
I PERMIT APPLICATION FOR: e___�r1 �e� J n2 S .I
Address: rJ Lf 0 6 1Ja) iV 1 Dr l v
Property Tax ID #: ;5 4 0 2 - CV 09 - 0 ZV" _ - 0 OCR Lot No.— 4J C)_
Site Plan Name: QJ R Block No. la
Project Name: Nor
1 n �1411 10 X 33 1 h s y l a-%� t�oF o r` -64156 na 10 X 31 .s lax 10
Cox _a 5 X 12 i?04 raKS ovate y.la4sr- So-�le n94- -
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit- check all that apply.
Mechanical
Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ to i bQO
_ Gas Piping
_ Sprinklers
_ Shutters _ Windows/Doors _ Pond
_ Generator _ Roof . Pitch
Sq. Ft. of First Floor.
Utilities: Sewer _ Septic Building Height:
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Name
Name: n A
Company: Maaq,, ncrzai nLLC
Address:_paim Me] ye.
City: F: 1+ " O WAt'ck Stater-
Address: 9 9 4 ad
Zip Code: Fax-
City:'F-�- U &X__ State: F:.
Phone No. III 2- S-ItM 17N a
Zip Code:3y19 S Fax:
E-Mail:
Phone No
Fill in fee simple Title Holder on next page ( if different
E-Mail IS Ct+ t-�i S Z 3 14 a q rna`i I • con•+ .
from the Owner listed above)
State or County License_ d O U 3
If value of construction Is 25W or more, a RJR ffl.Ng ce of Commencement is required.
If value of HAVC is $7,500 or more, a REC011090 e@ of 23 ke*ired.
--- ------ -- -- - -- - -- ------ ----- --- --- ---- -- ---- -- - ---- ---41;-m tisrequired,
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DESIGN ENGINEER: _�
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: F► t) rc d LA i M�¢r
LLC
Name:
Address:_ _41 U I 't arie, a in i
hm l U 6 4-101
Address:
City:1°df►-
State: F_
City: State:
Zip: 3345 2 Phone $ 13-
2-41- 3.2 7Z
.Tip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY: No_ t Applicable
Name:
Name:
Address:
Address-.
City:
City:
Tip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVNT: Application is hereby made to obtain a permit to do the workand installation as indicated.
1 certify that no work or installation has commenced prior to the issuance of a permit
St. Lucie County makes no representation that is graining a it will authorize the holder to build the subject structure
which is in conflict with amnry► a�pplicable Home OwnersA on riles, bylaws or covenants that may restrict or prohibit such
structure. Please consult w7tir your Home Owners Association and review your 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 SL Lute County Amendments.
The following budding permit applications are exempt from undergoing a full conwmency review: room additions,
accessory structures, swimming pools, fences, walls, sqm screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Nome of Canunencement may remit 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 attomev, before commencine work or recordine vour Notice of Commencement_
AA
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_Sign /Contracto Agentforowner
Signature of Contradw/License Holder
STATE OF RIDA
STATE OF FLORIDA
COUNTYOF
COUNTYOF
Swom to (or affirmed) and subscribed before me of
Swam to (or affirmed) and subscribed before me of
✓ Physical Presence or Online Notarisation
Physical Presence or Online Notarization
this ? day of T� ►..c . 2M by
this day of . 2020 by
Zoz c
Name of person making statornent. �
Name of person making statememL
Personally Known OR Produced Identification ✓
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced 1eivvs 11coAQA_
Produced
(SignatureNotary -
(S""rgnature of Notary Public- State of Florida )
• OBYHR.WYATT
Commission No. Commla�)329rA
Commission No. (Seal)
•= Eap1ru F&-WY Q, 2Q23
.. � `�''• Bab�dTlruTrglFdninte�naS00.365•T019
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