HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO WST BE COMPLETED FOR APPLICATION TO BE ACCEPTED. Jt
Date: Permit Number:(`�O ' tiJJcX�
RECEIVED
Building Permit Applicatio'n ocT 19 2020
Planning I and Development Services St. Lucie U_gunty
Building and Code Regulation Division Commercial Resider X19
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
eiddrPc4z- r-S ---I) Bk -560-ru
Property Tax ID #: (5'09� - G' (30 5- Lot No.
Site Plan Name: Block No.
46-A
New'Electrical Meter Second Electrical Meter
Addition-aliworkto be performed under this permit- check all that apply:
Yy echari'161 Gas Tank Gas Piping Shutters
)C� Elect'jri�' Plumbing Sprinklers Generator
r—, 1 - %2'.. , _X
LxWindows/Doors Pond
Roof / ZL Pitch
'ZCI 0 1 Z901
Total"S�'.,,!`Vdf Construction: Sq. Ft. of First Floor:
'C it 16t Cost 6 f' 6rf� u' ion: $ :3 E>00 can Utilities: Sewer X Septic Building Height:
Name :S \/"'C-;'55P' IN'1614a&
, - ,'
AddC
ni- 1 f,
'aTe:
o m p a n y:
City: FbItT 5T- LUC.-i-c-7 State:
'X8dress: 0 -5-, 4z"' Q.
Zip Code: -3 '45 �_ Fax:
City: F+ State: 61
Phone No. 7 Z - 3-ho
Zip. Code: - 349 & I Fax: 7Z_ A&G -rj 3
E-Mail:
Phone No we?;
Fill in fee simple Title Holder on next page if different
E-Mail 2110, �cit &uT
State or County License
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.
I
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-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 Count and posted on the jobsite before the first inspection. you intend to obtain financing, consult
with lende or an attorneybefore commencingwork or re c n r Ice of Commencement.
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DESIGNER/ENGINEER: _Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: ��y` 1?. �C��I�
Name:�''�t'� �2.�3�IT' U+�11�(�i
Address: I.���'�-' SG � �"� �
Address:
City: �3c, �l State: �_
City: State:'
Zip: Phone
-EL —
Zip: Phone: 3Z-1- 8i3'�Z �Z.Z.L
FEE SIMPLE�TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:'
Address:
Address:
City:
city:
Zip: Phone:
Zip: Phone:
Sign a caner/ Lessee/Contractor as Agent for Owner
Signature of Contra or{Cicense Holder
STATE F FLORIDA.
STATE OF FLORID
COUNTY OF Jk L�)C\�,
COUNTY OF_��t L to C,� �
Sv�rn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me
of
Physical Presence or Online Notarization
']� Physical Presence or Online Notar
this day of � 202q by
this •_]� day of �, 202Q by
o
l)� �� ��G C �
�'C7 CX k � Ct. vYl C��
o
Name of person making statement.
Name of person making statement.
Personally Knowrl��. OR Produced Identification
Personally Known � OR Produced Identi
N � wNN
p�
a�i¢r���
Type of Identification
Type of Identification
a'� o-�
a=
Produced
Produced
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Z
(Signature of Notary Pu c- $tateQ 'da �omrNaslon�HH 182146
(Signature of Nota ublic- State of Florida )
l'rt�' MIltd� Z0, 2022
Commission No. �� S=g���„�
Commission No. (Seal
•
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