HomeMy WebLinkAboutBuilding Permit Application,3
all APPi IrARI F INFO MI1ST RF COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: Z 6 1y ~ CJJ""7- 7`
O
7.7° -' Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: SGreedl room add/fzc�
RECEIVED
OCT 2 0 2020
St. Lucie County
Pe
itting
I`PROPOSED, IMPROVEMENT LOCATION:
Address: -7 I q 3 G a �l U 4 / YIQCe %�DY�" c�1 LGIC� � 6
Property Tax ID #:,541 q-5ol -166i'O -qw _1 Lot No.
Site Plan Name: wmrreri scre-en boo `-Ad-L-� 6-P Block No.
Project Name: VVarrm
DETAILED DESCRIPTION OF WORK:
Rn1LY 1 C)� Y 3,5 S ia.h 1,6�41 F".-1h tdaywl ifa
Zns c l l suze&n Yo ow 46,V i mszt . 7(_60d
�n-ln� doors
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _
Electric _ Plumbing Sprinklers _ Generator _ Roof
Total Sq. Ft of Construction: 340 Sq. Ft. of First Floor:
Cost of Construction: $ /2, 600 Utilities: _ Sewer _ Septic Building Height:
Pitch
.OWNER/LESS I EE:
CONTRACTOR:,
Name ,riles l3. %()l�161-le
Name: D anS7411c770; .
Compan�-
Address: z �(Q i3/min I Dv -
Address: 7/ 13 �,-ir P0-1-7 ' f �
City�n�� ��, CGt Gce- Stater-
Zip Code: 3 yq,<2 Fax:
Phone No. 5 &I - �09-537a-E-
Mail: M5bOS6V(k bellsoUs( .4e1L
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
City: jef'Le State:
Zip Code: �3� 951q Fax: 77a `f 7'13y�
Phone No % 7d 6-W ZZ Y'7
E-Mail c�dnh /11,�1�0%�OGc' -nef
State or County License C66 0360`10
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.
r
SUPPLEMENTAL CONSTRUCTION,LO LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
BONDING COMPANY: _Not Applicable
Name:
Address:
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 conflicts with any applicable Homeowners Association rules, bylaws or and 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 attornev before commencing; work or recordini; vour Notice of Commencement.
Signature of Owner Lessee/(fontractor as Agent for Owner HEATHER BUR -FORD
State of Florida -Notary Public
STATE OF FLORIDA
=' Commission # GG 183217
P�
'"?O' °� My Commission Expires
COUNTY OF iC-Ir `6"f
February 06, 2022
Sworn to (or affirmed) and subscribed before me of h/P ysical Presence or Online Notarization
thisZo day of 20by
Name of person making statement.
Personally Known OR Produced Identification o-.1
Type of Identification Produced J)L_
(Signature cf Notary Publi tate of Florida)
Commission No. (Seal)
,��`a'r'P'�� HEATHER BURFORD
,P oa%
��-State of Florida -Notary Public
=* ■= Commission # GG 183217
i 9OPOPP� My Commission Expires
m1"0``� February 06, 2022
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Rev 5/20/21