HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO
MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /� Permit Number: OS �0
Sa llo L�Vl1f _ RECEIVED
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OCT 8 2020
Building P.ermrt Application
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Plannrng and Development Service 5t.L nty
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Building and Code Regulation Divisiori Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982 - - --
Phone: (772)462-1553 Fax:.(772)462-1578. C13DG!Funding- .- - -
PERMIT APPLICATION FOR: �aosr_.-�•4.�'�1
PROPOSEDIMPROVEMENT LOCATION:
Address: C ,�L — `V
PropertyTax'ID#: +� "3�) "" (fl �`�-` c7 ]-,r iJb - 2- ; Lot No.
Site Plan Name: ou
,c1�1!�. Block No.,
Project Name: `h�g `-,C3��C �==C�V,U�i
DETAILED DESCRIPTION OF WORK:
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New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
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 �..2 Pitch
Total Sq. Ft of Construction: Z OQO Sq..Ft.of First Floor:
Cost of Construction: $ a Utilities: _Sewer ._Septic Building Height: 1
OWNER/LESSEE: CONTRACTOR:
Name f1'E�� vim- Name: "-76��
Address: ? L: .t, fa Compan d 4�v�CC,O-o-v"9
City: Stated Address: 7 OI �,�' c,.+s ' kn1,
-Zip Code: *tw 1 Fax:, City: 1 1 i State:7
Phone.-No,.-
E- Zip Code (r Q, ( Fax:
Mail: :Phone:No-7'7-"U_
Fill in fee simple Title Holder onmext page(if different E-Mail_ Ali
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from the Owner listed above) State or County License C CG i`33 a�e�o
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.
SUPPLEMENTAL'CCiNSTRUCTION'LIEN LAW INtORMATION
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 bran attorney before commencing-work or recording our Notice of Commencement.
Jna%re of Owner/Lessee/Contractor as Agent for Owner „
STATE OF FLORIDA
COUNTY OF
Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization
this day of 20_by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced
(Signature of Notary Public-State of Florida)
Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE _ MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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