HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED'
Date: �� �3'� Permit Number:
9U. RECEIVED
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F r OCT 4 8 2020
Building Permit Application St.Lucid County
Planning and Development Services Permlttoinlg
Building and Code Regulation Division Commercial Residential /�
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding
PERMIT APPLICATION FOR:
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PROPOSED fMPROV;ENIENT LOCATfON
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Address: Ca1�3 Di(, ,inSo n Texrace PO► S�loci �iF(, 3(652 -
Property Tax ID#: 3W5- lou - no V� - OCO` 9 Lot No. (�1
Site Plan Name: G' A n&f el nt. & Block No. �-
Project Name:
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DETAILED DESCRIPTION."OF WORK
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New Electrical Meter Second Electrical Meter (Affidavit required)
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CONSTRUCTION'INFORMATION
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Additional work to be performed under this permit-check all that apply:
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_Mechanical _Gas Tank —Gas Piping —Shutters _Windows/Doors
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_Electric Plumbing _Sprinklers _Generator 1► Roof i ly (�' Pirch
Total Sq. Ft of Construction: yU,�A.' Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: —Sewer _Septic Building Height:
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01N,NER LESSEE CONTRACTOR.'
Name_Le,&t . Smilb Name: oo
Address: u-ig3 DicxinSfn -Fumcc Company: i-l0lY1m>trR�o�`-tna R� XGt 'tCm
City: POril - uLat, -Stater Address: 3-AU. +i(AU
Zip Code: bLA`J�k Fax: City: P81+S);-L Wt State: FG
Phone No. -7'1A V31 '7 (A '�U E- Zip Code: 3"5 ) Fax:
Mail: Phone No_1_kZ1 •'SO1 " LI%U.3
Fill in fee simple Title Holder on next page(if different E-Mail (t(°('cX Lq�' 000%%nq.ftM
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from the Owner listed above) State or County Licensac 1331 82S
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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.
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SUPPLEMENTAL.�ONSTRUCTION LIENrLAUV INFORMATION' ,15t � t �� a f
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DESIGNER/ENGINEER: O Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address: i
City: State. City: State:
Zip: Phone Zip: 'Phone:
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FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: LNot Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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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 toobtain financing,consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
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Signature se as A ent for Owner
STATE OF FLORTLVu-e-COUNTY OF
Sworn (or affirm d)ar_d ubscribed before me of °� Physical Presence or Online Notarization
this day of 20ZJ by
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Name of person making statement.
Personally Known OR Produced Identification
Type dentificati n P uced
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gnwd rF--Gf:NotaQry public-State of lorida)
Com ' sion No. Yf M 5S) eal) ,.�;aJo�'o, DENISE ELAINE SUAREZ
�s Notary Public-State of Florida
r =• •= Commission 0 HH 52997
My Commission Expires
October 13, 2024
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