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HomeMy WebLinkAboutBuilding Permit Applicationate. T All APPLICABLE INFO MUST BE CO"nnrLETED FOR APPLICATION TO BE ACCEPTED Date: "�� �25 yPermit Number: ;' 10 qro 654 Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Rhone: (772) 462-1553 Fax: (772J 462-1578 r ;;,PERMIT APPLICATION FOR: Address: 60j %mac r11J6 71iJC-iiZiuE . Property Tax ID#: S�a9 `SAS (Zi - C,0© -7 Lot No. Site Plan Name: Project Name: New electrical Meter V Second Electrical Meter Additional work to be performed under this. permit - check all that apply: Block No. `mechanical _Gas Tank _ Gas Piping _ Shutters ­-Windows/Doors _ Pond _ Electric V Plumbing _ Sprinklers _ Generator ­�'Roof Z Pitch Total Sq. Ft of Construction: 3S6Z Sq. Ft. of First Floor: 35--0Z Cost of Construction: $ SZp,C)00, _ Utilities: —Sewer ✓Septic Building Height: Ze) Name :3eNWI f c&K*.1,i3Ob6 K&S i 6 Address State: Zip Code: Fax: Phone N E-Mail: Fill in fee simple Title Holder on n ag from the Owner listed above) 6E16 al Name: "` '�b�''t� � r%�i✓�� COn1 an � V�1�CGYJ� co,ii) e uc;nc-� R. Y_ Address: -~"ems" "R�u:� 1�d�'w�w�ae.4L L�J City: State: Zip Code: Fax: Phone No �)Z= Zt (,- I I E-Mail 7-4 tl _Soo-r[4 W67J State or County License ZO 7Z If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. 4 DESIGNER/ENGINEER: Not Applicable Name: ,ALA `Z . Address: t3i; se gfti�-"3A n�JE City: woc.-­6 State: r-1 Zip: 3�9 �z,. Phone' FEE SIMPLE TITLE HOLDER: -_)e Not Applicable Name: Address: City: Zip. Phone: MORTGAGE COMPANY: — Not Applicable Name: 60," 5-(­A--r& ..�NA-n3r Address: Lla l 1 z9 s-re:�' City: State: Zip: .13 0$C) Phone: %3 BONDING COMPANY: _O Not Applicable Name: Address: City: 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-instailation 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 Twill, 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 recordedin`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 nn attnrnpv hpfnrp cnmmpncing work or recordin"our Notice of Commencement. atom o er%Lessee/Contractor as Agent for Owner Signature of C ntractor/License Holder . STATE OF FLORI '` OF STATE OF FLORIDA- COUNTY. OF " COUNTY Sworn to.(or affirmed) and subscribed before me of w rn to (o(affirmed) and subscribed before me of hysical Pr sence or Online Notarization Physical P esence or Online Notarization -th' " 20Wby this 1 day of �7 .fig . 202Q by da . Name of person makin statement. � Name of person " atement. Personally Kno " OR Produced Identification Personally Kno R Produced Identification Type of Ides ification Type of Identification ' Produced Produced (Signature of Notary blic- Sty ,, rid AGOODMAN (Signature of Notary Pu ic- State ofp ida) '&aRM AGoODMAN `` * Commissiai # GG 198133 Commission (S IMarch20.Z022 0— 00MffV=T1#GGJ98133 Commission NK;- March20.2022 FOFF69r Ila W11nBud�e*toSm1ces 'I$e 1g10i dmlAedI"&.WNMy REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 5/b/1U