HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR AP'PLICA o iON TO BE ACCEPTED'
Date: �•�� Permit Number: G
ST LuCiE ~�
CUCIF -,I,- P ,
Planning and Development Services
Cc# c09.,).3
Building Permit Application
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address: 1 1S 1 E' EAS i
PropertyTax ID#: 3402— 604 -mma5-
Site Plan Name: Iia,N 1'Ve,\"
Project Name:
T
New Electrical Meter ✓ Second Electrical Meter,
RECEIVED
FEB 0 9 2021
perm�sr� F,g Department
Residential si. Lucie CountY
Lot No. 55 ±
Block No. �4
Additional work to be performed under this permit- check all that apply:
✓Mechanical _ Gas Tank —Gas Piping _ Shutters ✓Win/dows/Doors _ Pond
�lectric �/ lumbing _Sprinklers _Generator Roof .12 Pitch
Total Sq. Ft of Construction: C 5 Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer Septic Building Height:
Name U05U: ,DAMiAW
Address: 52 b l EDWAR95 AD
City: FORT PI � RC E State: FL
Zip Code: 549 92 Fax:
Phone No. -412. - 9 46 - 12 N -4
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: "TAS60 MEPR1 TT
Company: TNT 8UILDEIRS LLC
Address: q 8 1 SW SILTMORE ST
City: Pok--r S -r LU c I E State: FL
Zip Code: 34 983 Fax: -4-42 -344 -9461
Phone No -4 ?2- 3 44- 94maj
E-Mail 'TN T 'BUILD ERS L.LC <w— GoMCAS T. NET
State or County License Cni~ 151 -jr-964-
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.
117
DESIGNER/ENGINEER:
Name:
Address: Iq$12� f-i.)
City:
Zip: Phoi
_ Not Applicable
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: /Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 thergrantingof 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 attornev before commencing work or recadding vour Notice of Commencement.
nature of Owner/ Lessee/Contractor as Agent for Owner Sig ure of
STATE OF FLORIDA I STATE OF FLORIQI UJILa� COUNTY OF COUNTY OF
Swo to (or affirmed) and subscribed before me of
ysical Pr cp or Online Notarization
this day of 2020 by
VIA 10, , L(.Lw a 6)
Name of person making st
iv'a"Q% MELISSA MCLEOD
Personally Known V (Fekuce�9�'��irc�Florida
ommission 7
Type of Identification '•v M; ro,*.m.F.xoireslun23,2021
Prnrlucari . F `.. f_Er..tFrur .=.n:ralNotaryAssn.
Commission No. k / (Seal)
Swor o (or affirmed) and subscribed before me of
P ysical Prg5gDce or Online Notarization
this day of P1 2020 by
Name of person making statement.
Personally Known
Type of Identification ;•'�>:a�pil"••,
MELISSAMCLEOD
Produced
NotaryPublic- StateofFlorilia
Public
mission # GG 077709
My Comm. Expires Jun 23, 2021
Banded through National Notary Assn,
(Signature of Notary Public- State
Commission No.
(Seal)
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DATE
RECEIVED
DATE
COMPLETED