HomeMy WebLinkAboutBuilding Permit Application i
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:,\( Permit Number:
� o L�l�1UL5. RECEIVED
w a Building Permit Application OCT 08 2020
Planning and Development Services St.Lucie ermitti g
County
Building and Code Regulation Division Commercial Residentid V
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding l
PERMIT APPLICATION FOR: I
Gam-
PROROSE�D KAMMMEff lm ,
Address: 1.3�{ .1'T /V/aR^0"y,a. oi:✓
Property Tax ID t (91 104 O d V " 7 Lot No.
Site Plan Name: Block No.
Project Name:
1
DETAILED (3E�--GRIPTIfON OF WO �K:
✓n c,� ,ems..
New Electrical Meter Second Electrical Meter (Affidavit required)
�ONSTRUCTIQN INFOR AT O
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:
1
Cost of Construction: $ Mao - c2to Utilities: —Sewer —Septic Building Height:
OWNER/LE-}SSEE. C��NTRACTO
Name /2 b J'iC /✓/3l .^47A Ave e Name:
Address: /3'1 ,1°le'- N,9 Berry I`f✓-G Company: c LPe•;,*vc. exz-
City: A nT Jg i�� 1—tits It•t State:r c. Address:: 'S? si�' `d/9�Lr4r�-!'� lj�q ?c -c•
Zip Code: 34 `1 P Fax: City: LDr- 1P t State:
I �
Phone No. E- Zip Code: 3't is'/ Fax:
Mail: Phone No ✓r6/- N S
Fill in fee simple Title Holder on next page (if different E-Mail �• ifs�,r�.,►Lc.�y�`C-�l.d r<� -�Mva��y
from the Owner listed above) State or County License 4' CI a y (h ak L4,&
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
WORRIAME AL CONSTR C MIN LAW fN.f= A f•
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 conflicts with any applicable Homeowners Association rules, bylaws-or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 recording our Notice'of Commencement.
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Signature of Owner Lessee/Contractor as Agent for Owner
STATE OF FLOJIIDA
COUNTY OF k,
Swor to(or affirmed)and subscribed before me of Physical Presence or Online Notarization
this day of �cib 20-
4A by
Sal\-14r r\
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced F ��
(Signature of Notary Public-State of Florida)
Commission No�Nd (Seal) °DEANNAGIVENS
` � Notary Public•State of Florida
_� " 'Commission»HH 086359
'�®d��. M Comm.Expires Jan 28,2025
:..pp�.' Y
Bonded through National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev 5/20/21