HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
S�`L L `YU118 y ;
r� Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: E LE C-CR l C ILL.
PROPOSED IMPROVEMENT LOCATION:
Address: L+ U' c� FAL M ETTo AVE
PropertyTaxlD#:�� S� �- Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
=N S-T A'L-L 12 ab 2b PMP C.\RCu 1-V R>R, SEWER FLA-MP.
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
X_ Electric _ Plumbing _ Sprinklers — Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
1 a�
Cost of Construction: $ 460 • Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name RiMn 'ENEV_ FA [AEL
Name: CJAARLES . LDUOe
Address:54cz N1LMti`Ctc N)yn uG
Company:CW�RLES LoWC V-_ LECTRLIC. T'ti1C
City: VoRN to-RC.E State: FL
Zip Code: ► �ia�-- Fax:
Phone No.
Address-4S "ERNANDD Lorr. I NPT
City: f'ORT P! ERCE State: FL
Zip Code. J 49'41 Fax:
Phone Nk g 9M 3� 2 -9
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
_l
E-Mail Q E 1 i[ tcTne. Q.6 - C D
Mate or County License EG O 108
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
Name:
MORTGAGE COMPANY: , Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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.
1 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 contlict 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 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 commencine work or recordine vour Notice of Commencement.
Signature of Contractor/License Holder
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF �-�` 1A Cie)
COUNTY OF ,SA ' ��`�4`i)
VrS n to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
S rn to (or affirmed) and subscribed before me of
WPhysical Presence or Online Notarization
this � day of �(�I��, 202V by
this +�` day of ]LCC= yV- 202t by
QYVWLS, L
fS L iD w)b
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known Z OR Produced Identification
Type of Identificatio
Type of Identification
Produced
Produced
Notary Public Slag of Florida
�r71,_ Notary Public Staa of FWnds
Sabrina M Arrington
; "` T, Sabrina AA Arrington
`
Signature Notary PubI - f FfdJl@J'�i r2712o23
(Signatur of Notary Public- S to rid ers Oa/2712023
No {Seal)
Commission No.Commission
i01 (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20