HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: k RECEIVED, Permit Number:,
"71
OCT 18 2020
St,Lucie County
P r ttin
_.r-.___-____.__._. ...._ BU a� � Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772) 462-1578 Commercial Residential _
PERMIT TYPE: n_
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Address: 33o�_tnn rzxhv Fi Pr Yu�� �,�-7
Property Tax ID #: -_ Z'-t i `7 Zl q- 0C)0 3 6Cy) i" Lot No.
Site Plan Name: (Q�''S-C �u- Block No.
Project Name:
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Additional work to
be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters -_Windows/Doors,:
Electric PI{urnb'ing .� Sprinklers ^Generator• _, ,Roof. Pitch
f Z RoLL-
Total Sq. Ft of Construction: 1( U'IJ Sq. Ft. of First Floor: ,ru,
Cost of Construction: $ `13SD - Utilities: —Sewer —Septic Building Height: I
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Name... NAA) AAL&.?- i Name:
Address: Di, pRLJ15-n0 LA/ s- Company: 5io,uCuac�k� fv u�C� I•
City: State: Address:•,�z ?> oc Esau r�✓
Zip Code: 'Fax: 'City: % r���"-� � Stater_
Phone No. i0"z. 2V 't2`-" Zip Code:---,ff S'Z Fax:
E-Mail: Phone No 777 716 -S'6q`Y
Fill in fee simple Title.Holder on next page(if different E-Mail r" e
from the Owner listed above) State or County License L L $�. 7 �G
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required,
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DESIGNER/ENGINEER: ` Not Applicable ••IVlORTGAGE COMPANY: �Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone 2i.p 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 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 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 YOUR PAYING
TWICE FOR IMPROVEMERlTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO AIN FINANCING, CONSULT
WITH YQ R 0 R OR AN ATTORNEY BEFORE RECORDING YOUR NQTJ COM NCEMENT."
Si ature essee/Contractor as Agent for Owner Si nature of ontractor/License o er
STATE OF FLO A STATE OF FLORIDA��.
COUNTY OF LC,1CJl� COUNTY OF " (�UUL
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of b— ljeC , 2Q-L by this [ day of r 20�j- by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced .Produced
(Si nature o Notary Pub ic- tate of to I (Sig ature f Notary ub icy loridpq)r
HERfNE JtWIEN Z o HERINE,,,,
Commission No. o Notary p blic,State of Florida i NCor(fi� t'State NEZ
Commission No.6 C of Florida
i Sion#GG 921213 My comm. � n#GG 921213
9A•v comm,expires October 8,2023 expires October
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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