HomeMy WebLinkAboutBuilding Permit Application Beck, Ken and TaraAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
° e �' - Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential ,i\
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
f 1 Address: o c. / r' /�/t y- E 4 q_ 577 _
Property Tax ID #: 451 I — SI10 OO) a —Qd 0 - 9 n ,, 1 ,, J Lot No.
Site�� n Name: ISIdnd Cr
eS-� Con o�n.n'um unit 1V� GU'Yl uY{/�11/ ,Y Block No.
Project Name: . _ C I A c0(i71? api e
DETAILED DESCRIPTION OF WORK: J
i S ` G! r
11 WInAw m + n211
New Electrical Meter Second Electrical Meter (Affidavit required) t"G676
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CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters K Windows/Doors _ Pond
_ Electric ---, Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: Utilities: —Sewer _ Septic Building Height:
Name net CCk
Address: /01/80 S caan Or 62"�
City: dw5zo &Act) State: r—
Zip Code: (3 qq 7 Fax:
Phone No.
Mail:
Fill In fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name: N-41-vAsr M P : P�-,i
` Company: bye, bM COn14-ur+,:,9n LLC
Address: MS?) AhA/ NM_M&0c & K F-ki ka 4
City: L7 State:
E- Zip Code:,Fax:
Phone No %.�-
E-Mail
State or County License
IE If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. I
1 If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. 1
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name: _
Address:
City: -
Zip: _ Phone —
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
_ Not Applicable
State:
Not Applicable
Zip: — Phone: _ _
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: _ State
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
_Not Applicable
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 apd 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 attorne , before commencin; work or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF -,. ;f' L LI
Sworn to (or affirmed) and subs ribed before me of v' Physical Presence or Online Notarization
this _L_ day of I 20al by
Name of person making statement.
Personally Known OR Produced Identification 'DL'
Type of Identification Produced
(Signature of Notary Public- State of Florida)
g_Z,se Nelwy PubAC Stab N Flaridv
Commission No� (Seal)Tiny M t'hummond {
My Ganml�sion GG 92�i97
a Expim 101IN2023
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED _
DATE
COMPLETED
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