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HomeMy WebLinkAboutBuilding permit appDESIGNE Name:_ Address: City: Zip: NGINEER: Not Applicable Phone State: FEE SIMPLE TITLE HOLDER: Not Applicable Name:_ Address: City: Zip: Phone: MORTGAGE COMPANY: — Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: Not Applicable Name: Address: City: Zip: Pho 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 lender or an attorney before commencing work or recording our Notice of Commencement. c�3 vim' r v 61V %il j [ i -� �� (► ` -,�_ for as Agent for Owner I Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF I >,,>JC COUNTY OF 'S - (, u,-(.-@ Sworn to (or affirmed) and subscribed before me of Physical Presence or` - Online Notarization this .9C)day of 69( ) , 20 0"y Sworn to (or affirmed) and subscribed before me of P ysical Prese ce or Online Notarization this ;day of 20 D- �y lug Name of perso making statement. Name of person making statement. Personally Known _ Type of Ideptification Produced l i Ivo, OR Produced Identification Personally Known OR Produced Identification Type of Identificati n Produce_tVI S C,ICe� CATHERINE JIMENEZ % ,� CATHERINE JIMENEZ S natu e of Notary Publ t low.wy)i'ublic, ata e o (Sign ture of N ary Public- ~t i ry Pudlic state of Florida Commissi^nGG 921213 I or.imission# GG 921213 Commission No. My dal �;,��'res October 8, 2023 C I ini nrt gKp,res October 8.202; r )��.. ,-.� Commission No. REVIEWS FRONTZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division Commercia 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Residential Address: f L2 ec 0 Property Tax ID #: 3q / L./ , j b 1 63 1 `_ LA (22 ALot No. Site Plan Name: Block No. Project Name: y . 7 { Ll �C+j� y� l 12— "x New electrical Meter Second Electrical Meter Additional work to be performed under this permit– check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond _ Electric _ Plumbing _ Sprinklers — Generator _ Roof Pitch Total Sq. Ft of Construction: �/�®C.) Sq. Ft. of First Floor: _ Cost of Construction: $ IO 4 "e Utilities: _Sewer _Septic Building Height: Q{{{� /■yy\ fj, .[.�.a.�,, ay ``` '^\"'"" n.�,.. y 3 ,.7f.1'l w q 4C c �1^ T� , L jai {` .RfIIV�E4 LV C hP Name Name: o` Address: Del-_ Company: Vt w^ e ZpF �w City: -eState: R Address: d00�- Zip Code: �5� Fax: City: �ov'� ��v1 ti State: Z �� Phone No. I I 145® 2 Zip Code: _31_f 98-T Fax: E -Mail: Phone No © < E -Mail 2– ` e Fill in fee simple Title Holder on next page ( if different from the Owner listed above) State or County License G6 -G If value of construction is 2500 or more, a KtLUKutu NoTice OT commencement is required. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. a