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Home My WebLink AboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: I -- r� " i 3 Permit Number: POO ow Building Permit Application Planning and Development services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce Ft 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial '� " Residential PERMIT APPLICATION FOR: Address: Ll I Cs n [A I (A ( ) ("1 I -- l 30D,. fA Legal Description: Property Tax ID#: t LI '_4J sou ' ©coci - 000 Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: Cam, S inc i it 1�_e i q r ► c) Y-t Lot No. Block No. echanical Gas Tank — Gas Piping —Shutters — Windows/Doors Electric _ Plumbing — Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ L _1 ':�00. 00 Name irCrti Generator Roof Pitch Sq. Ft. of First Floor: Utilities: Sewer _ Septic Building Height: Address: LI I C_v Q n A I UI"t l I �DaA _ City: 4� IrC State: �l - Zip Code: �-�� L Fax: Phone No. - LA OL4 E-Mail Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name:-� er-N L-hi fir K_ Company: i\1+r l I Address: LD903 C City: I ff C-State:-.E_(- Zip Code: 34951 Fax:7*13- k-��n� PhoneNo_I-ID- 1P3L1-04C11 - - E-Mail (Cecil i �''fcz, Cwr-) State or County License �tC ► �� If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. � �� k��CC�IVSTF3lJCTI�N LIEN L�Vv IN�C�RIVfAT1(�i� _ 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: 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 wilt 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, wails, 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 your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. Signature f Owner/ Lesse` o ractor as Agent for Owner Signature eContractor/Lice(tejoi&r STATE OF FLORIDA �T STATE OF FLORIDA COUNTY OF l� �l f COUNTY OF a � ri ,w' The for oing instru ent was acknowledged before me �Anyri� The for 'going instrument was acknowledged efore me 20 l by thisdayof 20jgby this_adayof (KLaAe of person ack wled ing) (NAT4 of person ackn �A CATHiE LEE STULL = 2 ♦ :? �c� rPUe"':. CATHIE LEE STULL " ° NOWY Pubiic - State of Fo^da * NolNYPubi''c- StaleGfRonda i =: + Commission-GG"5ovsl (Signature of Not ,., 2ttat*Dm ,ft WWA.j27,2022 (Signature of Notary bil'e�`ate OffdF7d3esJan2T.2Q22 Personally Known OR Produced Identification Personally Known V7 OR Produced Identification J� Type of Identification Type of Identification Produced Produced 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 ev.