HomeMy WebLinkAboutapplicationAll APPLiICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: IQ- .L "711 Permit Number:
(� l LL! CUL
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential V/
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
F, Address: 5300 Echo 1'lntrt t C-aL - I;yC4-,
Property Tax ID #: - 5-00 -OI'38 ' (�� - Lot No.1?�q_
Site Plan Name: Block No.
Project Name: 14L.aI��
DETANILED��CD--ESgCRIPTION Root
WORK: hOU_� t'' s I- �7oo'b Re- - 0-:i C�r+�- 1-1041/1 fir-/N 191 &
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: 3 ao
Cost of Construction: $ 3 s�To
Windows/Doors
Roof
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic
Building Height:
Pond
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name o
Address: S3Q8 �. �ll�� iws t".�/cl t
City: 154, Rif-, c4... State: KL
Zip Code:.3NFl- I Fax:
Phone No.'s??, - 9 7q • -7-1 ok E-
Mail:
Name: ez- 'M. s
Company: 1oJ14 LGC
Address: /i'od et.J.-r jd�tr�
City: _ State:
Zip Code: 3-ZA ?J'_ Fax:
Phone No 32-1 7A 'Vq0
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail
State or County License CCe— /33z I.J"J-
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 CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name:
Address:
City:
Zip: Phone
State:
Address:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
J 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 vour Notice of Commencement.
Signature wner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OFBR 40
Sworn t,9(or affirme I) and subscribed before me of Physical Presence or Online Notarization
thisIL, day of 202 _1 by
Name of person making statement.
nC
Personally Know vOR Produced Identification
Type of Identif. ion Produced
(Signature otary Public- State of Florida)
lorida
Commission No. No=GordY
Sh�1
My8341XdF
Ex
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
kev J/LV/L1