HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll 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 C
mmercial Residential--
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATIO_ N1
Address: ! ui )Q
Property Tax ID#: 1.3 00 - O 16
000 S Lot No.. �(7
Site Plan Name:
Block No. -G S
Project Name:
DETAILED DESCRIPTION OF WORK:
ear �f 2x is {' n r
f ( now SkingILS
Cil c la tr\�,
New Electrical Meter Second Electrical
Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this perm
- check all that apply:
_Mechanical _ Gas Tank _ Gas Pi
ing _ Shutters _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprin
ers _ Generator _jL Roof /a'I Pitch
Total Sq. Ft of Construction: alba
Sq. Ft. of First Floor:
Cost of Construction: 5 I,) 000
Utilities: -Sewer Septic Building Height: �- Sfooil
OWNER/LESSEE:
CONTRACTOR:
Name Li 6a
irn%I
Name: 3ricl
Address: 1V30fo F`Ct
City: TO r } 'p i Lr C-L Stat
Company: Iro-cl t'z S2o�fing
: f
Address: 121f, 6,A r'& \ Mott S}.
Zip Code: 3496 Fax:
City:'()r S'3r• LQ--� State:FL
Phone No. -7 Da
Zip Code: 3S90V Fax:
E-Mail:
prent
I
Phone No -7"74 - 110 - al 11 0
Fill in fee simple Title Holder on next page { If cliff
from the Owner listed above)
E-Mail 1 C Zoo i 14G pa (.e rv�
State or County LicenseS 3
If value of construction is 2500 or more, a RECORDED Notice
If value of HAVC Is $7,500 or more, a RECORDED Notice
of Commencement is required.
if Commencement Is required.
ltu'`4'�d-',tta'�4`'+kVPr."rYT1'r¢`
r
Name:
Y}t9M.Y"=.,,ls``'mF'tTkyjvc.+
Not App7c-,,ble
&7a,.`�,+.,��'z 2
PANY:
Name:
I Address:
City:
Zip: — Phone -
a, 4' !iJs� etiti 'f
Not Applicable
State:
Address:
City: State:
Zlp� Phone
FEE SIMPLE TITLE HOLDER:
Name:
Not Applic
COMPANY:
Name:
Not Applicable
Address:
City:
I
—
Address:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is ereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced pri r to the issuance of a permit.
St. Lucie County makes no representation that is grantir
i a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners A
structure. Please consult with your Home Owners Assod
ociation rules, bylaws or and covenants that may restrict or prohibit such
ation and review your deed for any restrictions which may apply.
In consideration of the granting of this requested perm)
I , I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Build'ng
Codes and St. Lucie County Amendments.
The following building permit applications are exempt f
m undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, sig
s, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a
gotice 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 bef
re the first inspection. If you intend to obtain financing, consult
with lender or an attorney commen
I:
ing work or recording your Notice of Commencement.
kL.
Signature of Ownerk esseq6p6r as Ag
t
n Signature of n older
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF GUGi a
Sworn to (or affirmed) and subsc&9
3
" Z
g Sworn to (or affirmed) and subscribed before me o o
Presence orNota
o Physical Presence or Online Notarizati 3
thisPhysical
day of JPr✓
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this day of -rAA. 2020 by N.
}Act[°9.
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rifzn Ka16n Zm"-0
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3 I Name of person making statement. ?:
G) m
Name of person making statemea _
Personally Known �— OR Pri
Personally Known OR Produced Identificati n "' o
Type of Identification
Type of Identification Nam_
,'.
Produced
Produced m
(Signature of Notary ftElic- tato of Florida )
(Signature of Notar ublic- StAWof Florida)
Commission No. 66o2>i4M4 (Seal)
Commission No. Z7// j (Seal)
REVIEWS
FRONT
ZONING
S E
OR
VIEW
VON SEALE
MANGROVE
COUNTER
'', REVIEW
RE
EW
RE
REVIEW REVIEW
COMPLETED
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