HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,�,� Q
Date: 09 _21- 2OZ-0 Permit Number: �ay - O W " l
�jjj (�77 RECEIVED
p SEP 2 2 1010
Building Permit Application
Permitting Department
St. Lucie County
Planning and Development Services
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:
PROPOSED IMPR,QVEIVIEIVT LOCATION
Address: 3 7G `i ?�/VbuL,4 t�112 5Pp 12T ST Luce- f L 35(5?3"2-
Property Tax lD#: 3`f Z S 70(c) -O LS-/ Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCO
RIP O[v OF WRK
�P� �L 4-l.�,9-Tz-72 cel-riot 34 c s G-z e----c r-,e r C
New Electrical Meter Second Electrical Meter
CONSTRUCTION ICVFORIVIATION t F
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: Sq. Ft. of First Floor:
Cost of Construction:$ /`' ��. Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE r: -T bR Gr "
Name �%/),O/V,#-S CAk its 0 Name: 1,t o&j �G,,2 G- �
Address:- 3 70 182.-W ,u A C/2 Company: -4Zf T PL01213I0G 4- X,4j,44
City: Pb-"T S! Lau' State: FL Address:_ *6- isC)/C /V(. W
Zip Code: 30 6-Z. Fax: City: a#IT-.SA L[?Z NCD State: �-t-
Phone No. 7 7L - 3 )(,/- 993 Z Zip Code: 3)(ff Z Fax:
E-Mail: Phone No-1 71 -2X-0 -7S-77
Fill in fee simple Title Holder on next page(if different E-Mail 1 Nr0 (� 6?P 6 o PLuua B,J G
from the Owner listed above) State or County License CF c !`(3 O 2..Y-)(
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: _ 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 will authorize theermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or andcovenantsthat 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,1,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 Nztice of Comme ent.
i
Signature of owner] essee/Contractor as Agent for Ownerignature of ContractorjLicen a 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_2:D
--day day of - _(? may) ,2020 by this z ,)__day of c\-mf' � 2020 by
Name of person makin tatement. Name of person'making staterfient.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identificati n.
Produced V
Produced
(Signature N (Signature of t {�, iJCic..StaiEELbfEI4bt! G H N
r
ELLE ,r° State of Florida Notary Public
Q Gammission # � 0079
Commissioe of Florida Notary
Public Commission N {{
ion # «6e�7)?fl85g ommissiEStiires
yCammiss'son Exp ''ft"i%N October 22, 2022
October 22, 2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
i