HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE UMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ' 1-7 oti �o��J�' �-'1N Permit Number: n O I
9
�,_�Q`�p RECEIVED
P a o c� o o n -- `' Building erm t Application lication MAR 17 2020
Planning and Development Services
ST. Lucie County, Permitting
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: 5INC, L£ FA I1 lk-/ RESIDE Ayr,' '
PROPOSED IMPROVEMENT LOCATION:
Address: fo 8�.$1
S_ CKEAN 12 R
Lb-r 109
2f-N,3tAl BgAci4, Ir L 3119P7
Property Tax ID #:
$ ! O O l l to
() OO q
Lot No. J O B
Site Plan Name: W1 AJ D r1lLL V'ILLAG6 Block No.
Project Name: EA i2 Ly
DETAILED DESCRIPTION OF WORK:
cororT900- A 91NGLc rgnI
New Electrical Meter % Second Electrical Meter
CONSTRUCTION INFORMATION: 7�71
Additional work to be performed under this permit —check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
X_ Electric )( Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:, / °� 9 Z Sq. Ft. of First Floor:
. ov t
Cost of Construction: $ IRO, 6 � S- Utilities: Sewer _Septic Building Heights 6'+i
OWNER/LESSEE:
CONTRACTOR:
Name 76 l lNJ iQ Q LY
Name:
Address: l08 S l S. 'a DEAN DR LoT' 10 7
Company: . L. 8P, E PU
(?V J L X AJc-
City: 71C 01 E,!O 13 E AC; la State: 9
Address: ,2 01 W W K a rvey 04
Zip Code: :2 95? Fax:
City: 3 U Q ( TE R
State:,
Phone No. '132 331 Olr
Zip Code: 13 4 6 8
Fax:
E-Mail: :"efiRLX I A ChA'L. COM
Phone No rGI
(D a3,;?,
Fill in fee simple Title Holder on next page (if different
E-Mail K L B A660 1 t)
Y-4 4400 • C o M
from the Owner listed above)
State or County License C 6
C. 03
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/!ENGINEER:
_ Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name: PRAx% lS L ll.6
DER
Name:
Address: 2 2_Is 4 6TP Atilt
5 E
Address:
City: VERO 65'cA C 14
Zip:3a.9 Phone_ 7ha
State: r—S.
i2a 14s'o(2
City: State: _^
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
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 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 County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with IPndPr nr an attornev hefnre cnmmencinE work or recordine vour Notice of Commencement.
Signs e�of,�Owne/.-L' esseContractor as Agent for Owner
--Sigrature o Gontract�Q�icen�e Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
Sworn 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 Notarization
this day of 2020 by
this day of , 2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Personally Known OR Produced Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/b/ZU