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HomeMy WebLinkAboutBuilding Permit Application- ^ t All APPLICABLE INFO MUST BE COMPLEI ED FOR APPLICATION TO BE ACCEPTED Date: 1"6- J0Q_f Permit Number:_ W) V )— 0_�3 ) JAN. ! 9 2021 Building Permit Applicationj Permitting Planning and Development Services St• Lucl Building and Code Regulation Division Commercial Residentia 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 E �ep.artmen oun— ty� i PERMIT APPLICATION FOR: j,r N7��TASrjG�- P'R0V SED I'MPRi0UE11/IEN f LOCATtONr j Address: S Property Tax ID #: Site Plan Name: Project Name: _ DETAILED DES,CRIPTLONi OF WORK':: 0 New Electrical Meter )(eS Second Electrical Meter n o G.ONSTRUCTI°QN IN.FOR:IUTATI0N: Lot No.�' Block No. :Z I_ Additional work to be performed under this permit- check all that apply: _klVlechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors — Pond _X'Electric 1[Plumbing _ Sprinklers _ Generator A- Roof 6 t Pitch Total Sq. Ft of Construction: 6 6L5a , Sq. Ft. of First Floor: 1 54 r Cost of Construction: $ -►�- 7 Li s� Utilities: —Sewer X Septic Building Height: + - 1 Q:INNER/LESSEE. , CONTRACTOR:' Name N efiarn e 5WC_ALev ri�r` Name: 11We nual P.ci Address: 313 N W 5` /'�� a/c� LfY, Company: Poo-+ 5`fi Lta- -r_- City: State: Zip Code: 3ftJ'5,? Fax: Phone No. Address: SW P5L &Vd City: INr+ S4, Stater• Zip Code: '5gy!?41 Fax: Phone No 7 72-- E 1C " 3% 76 E-Mail:_W Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail iQ 51 r1fllp a I Q 4JO&I I Oln State or County License G If value of construction is 25o0 or more, a KhLUKUtU Notice OT lAmmenLC1 nCuL m ICLJUu cu. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. SaJ'FPLEIVIENTAL C'ONSTR scnlO.N ft,N' L ,,WA/ 1'NF© "MATION . DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: f\ % Mi Name: Address: •J . C Address: VC—� State: City: State: City g2 Phon Zip: Phone: p: FEE SIMPLE TITLE HOLDER: '%C7 Not Applicable BONDING COMPANY: _ of Applicable Name: Address: City: Zip: Phone:_ Name:_ Address: City:_ Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to ao ine worK ana 1r1b1.a11d1.JUJ I tlJ 111U1�0«u. 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 structure. Please consult with your Home Owners Association Association rules, or for any re covenants restrictions at which may strict alprohibit such 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 yo intend to obtaa. inancing, consult -e,.�_ i__�__ .. ... .,��,..-...,., t•..,f.,ro r�,m mnnrincr Wnrle nr rprnlrfllnA vn� Notie of Commencement. witrl lenuer or a" CILwiiic -- Signature of Owner/ Lessee/Contractor as Agent for Owner ignature f Con ctor/L' ense Holder STATE OF FLORIDA STATE OF FLORID �..�C ;� Co ' COUNTY OF COUNTY OF Sworn to (or affirmed) and subscribed before me of Syrorn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization Physical Presen Online Notarization this day of , 2020 by this _LS?Iday of ZJW— . 2Q211 by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification pprc._n._lIg Known lt;4� OR Produced Identification Type of Identification Type of Identification Produced Produced Signature of Notary Public- State of Florida ( ry ) of abin L Bowen ( g Y ®bin L Bowen (Signature of Notary Public- State offfO% (Seal) ��^naIMy Commlaeio0 23 2 '1 )2>rPlros oa/oarzoza Commission No. al}� Commission No. REVIEWS :FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE NTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 5/ b/ 20 K5(7�n2 SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address:NWlikiek--e- Address: City: State:_ City: State: Zip: Phone -1"1 a. S21 S Zip: Phone: FEE SIMPLE TITLEHOLDER: _ of Applicable BONDING COMPANY: _ of 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. Inconsideration 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 befgre commencing work or recording o otce of Comn3encement. 4. nature f OwD r/Lessee ontracto as Agent for Owner natu of Contractor/Lice e Holder STATE OF FLORIDA STATE OF FLORIDA _ COUNTY OF 51 kA_y_A 'e COUNTY OF SC' LK50-e, Sworn to(or affirmed)and subscribed before me of Swpyn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization 'e`Physical Presence or Online Notarization this tCPh day of l`74)n 2020 by this jLll�t day of 00vn 202J 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 Ddm L PA3yn k (Signal of Notary Public-S gnature of Notary Public-State Notary Public State of Florid �bin ary Public State of 101 a n L Bowen �P L Bowen Commission No. (oG q �40 C mission No. .Z�� aly mmission GG 290212 Commission GG 2 2 1 w w Expires 021 4l2023 j or h Expires 02/p4C2023 1 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.