HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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L c u r; —�=- Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: A SQn+ct mo-cia C,+.
PropertyTaxlDti: 3c•i@-)- S-0a - OSL/r•{- 000-0 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
leap O�4 9Y.iS�ine coal and iris+nit ntw r; rs•,
_aid
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator X Roof s/la Pitch
Total Sq. Ft of Construction: ..2105 Sq. Ft. of First Floor:
Cost of Construction: 5 dry, 906 Utilities: _Sewer —Septic Building Height: Z S¢OriL
OWNER/LESSEE:
CONTRACTOR:
Name Ihomcls S. Srni4h
Name: Brig,% get1ont
Address: R San f•a Maria C,:
Company -rr Q SUft CeasF 1zoo+1i 11J
City: !?or; 5+ (,y4e Statef4,
Address:1'16 SW
City: ,'Du—S{.. ZOUL State. re
Zip Code: 3yq ri Fax:
ZiPcode:3gg5a Fax:
Phone No. -7]JS- G118
E-Mail:
Phone No 77.1- 370- 97>v
Fill in fee simple Title Holder on next page ( if different
E-Mail 1 GQ v 0 �� na L6c A C m Q i CDM
State or County License CCC, / 3 30653
from the Owner listed above)
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.
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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-residentlal 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 befpre the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording your Notice of Commencement.__ _
v o �
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Signature of Owner/ s e/ 11ntractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
g Physical Presence or _____Online Notarization
this �tZday of CS v%m 2020 by
Uri cln madooty
Name of person making stateT7,lent.
Personally Known 1t OR Produced Identification
Type of Identification
Produced
nature of Notary Public- State of Florida )
Commission No. .i /3— Z.J (Seal)
REVIEWS FRONT ZONING i SUPERVISOR
COUNTER REVIEW 1 REVIEW
JOSHUA REDHEAD
Notary Public -State of Florida
Signature of Con r icense Holder
STATE OF FLORIDA
COUNTY OF 5�• Lucut
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
this .al-46 day of 3 wu 2020 by
'riOri t•la1one4
Name of person making statement
Personally Known K OR Produced Identification
Type of Identification
nature of�otary Public- State of Florida )
CommissionNo. 23 (Seal)
PLANS IVEGETATION ' SEATURTLE MANGROVE
REVIEW I REVIEW I REVIEW REVIEW
ublic-State of Florid
ssmn # GG 311366
My Commission Explroa
March 13, 202: