HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �b`?,d1� Permit Number:
9U° Wools - - SCANNO
BY RECEIVED
O
- °ding -Permit Application OCT 3 0.. 2020
Planning and Development Services permitting Department
St. 4ude County
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
hone: (772) 462-1553 Fax: (772) 462-1578
ERMIT APPLICATION FOR,
PROPOSED IMPROVEMENT LOCATION:
4 IZ-e"(
Pro a Tax-IDI: L 32 / z 3 l O �— Lot No.
x� :qT
Site Plan Name: Block No. Z
Proj' ct Name:) ��i ✓ h
DETAILED DESCRIPTION OF WORK:
New Ellectrical Meter _X Second Electrical Meter
CONSTRUCTION INFORMATION:
Ad
_M
)CEI
Total Sq
I work to be performed under this permit -check all that apply:
hanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
tric _ Plumbing _ Sprinklers _ Generator _ Roof _
t of Construction: Sq. Ft. of First Floor: _
nstruction $ 1 a( Utilities: _Sewer _Septic
I
_ Pond
Building Height:
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name ii I.1 �J k.-f
Name:
Address: 0l !� �� 1/I',4,0 -)--,"
Company:
City: i , (' State: _
Address:
Zip Code:�� I�Kf tf Fax:
City: State:
Phone No.II o
Zip Code: Fax:
E-Mail: l C-f oie/ G�v°y
Phone No
Fill in fee siri�ple Title Holder on next page ( if different
E-Mail
from the O l� ner listed above)
State or County License
value of construction is Z500 or more, a RECORDED Notice of Commencement is required.
u
value of HAVE is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
O,,III NER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I zrtify that no work or installation has commenced prior to the issuance of a permit.
Stl 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 Lrisideration 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.
Th II following building permit applications are exempt from undergoing a full concurrency review: room additions,
acci ssory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
W RONNG TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
mprovements to your property. A Notice of Commencement must be recorded in the public records of St.
lucieCounty and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
i ith lender or an attorney before commencing work or recording our Notice of Commencement.
- igil ture of Owner es ac or as Agent for Owner
Signature of Contractor/License Holder
ST E OF FLOTr
STATE OF FLORIDA
CO NTY OF . L� c
COUNTY OF
Swo to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
hysical Presence or Online Notarization
Physical Presence or Online Notarization
this O day of CS c� 2020 by
this day of 2020 by
Name'of person making statement.
Name of person making statement.
Persor i Ily Known OR Produced Identification
Personally Known OR Produced Identification
Type of Ide tification
T�
Type of Identification
� �—
Produej d
l�
AA
Produced
(Signature of Notary 11bI1 Y, DNppgpRIEGIVENS
lgnature of Notary Public- State of Florida )
�MISSION # GG 02202
Commis ion No. a- :+S:December16,202o
mmission No. (Seal)
13.1 F� Bonded Thru Noiw y Public Undewft)n;
REVIES
FRONT
'ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
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COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVE
DATE
COMPLETED
ev.