HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �. ]��•�� Permit Number:
RECEIVED
2
RN SEP 2 5.1010
.. permitting Department
Building Permit Application St. Lucie County
Planning and Development Services
Building and Code Regulation Division Commercial Residential �G
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
c -
A31
Address: s'�ab 4te-"o « pg= F: Pteco-cam ciAF2
PropertyTaxlD#: SydZ &og 62Z`t 0®0 3 Lot No. II
Site Plan Name: /T.45-6 c^N Lei Block No. 5`8
Project Name:
14
New electrical Meter Second Electrical Meter
CQlVSTRUCTftJ INEOR�ATiaN K a y
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 Wf�t Pitch
Total Sq. Ft of Construction:: `Z5�� Sq. Ft. of First Floor:
/ [Z
Cost of Construction:$ 7� /ip Utilities: —Sewer _Septic Building Height:
Q11NER/LESSE ,P3 arC�INTRA QR�
�R',:���
....y,.. .,x.. �.'.. �.z
Name.,:-.��t�R�6i �► J ess�vt ec S�Pr inn Name: 1rw Lrc iJ C`;&S to,cl C CA a�r
Address: 5-Seg"(� i4«r_oaz� D Company: C ��o u�,c ��[, LLf-
City:21 Jer as :.., State: Address: ?7--2 Ave
Zip Code: 3q6ug Z Fax: City: ri State:rL
Phone No. 772 5-70' S 7S4 Zip Code: 3" S'-2 Fax: `7'12 Lf(,f-�,(�S
E-Mail: Phone No -n,?-
Fill
n,?Fill in fee simple Title Holder on next page(if different E-Mail CAS-�,�Uuay ,�wsb �sw�re cmc CPQ
from the Owner listed above) State or County License C �o X73 t ta� 7
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.
DESIGNER/ENGINEER: T 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 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 t your property. A Notice of Commencement must be recorded in the public records of St._
Lucie Count d posted on the jobsite before the first inspection. If you'i ,end to -financing, consult
with len o or a►i a ne ,before commencingwork or recordingour o Commertcement.
Signature of er Le o cto'r as Agent for Owner Signaure of a older .
STATE OF FLORIDA STATE OF FLORIDAf
COUNTY OF � � L)CJ`�--- COUNTY OF L'"4 LU+=(fes
SWVK,to(or affirmed)and subscribed before me of Sw000(or affirmed) and subscribed before me of
Physical PreqQnce or Online Notarization Ph sical Pr nce or Online Notarization
thi day of ( 20GC-�by this day of 202by
Name of person making
gsstatemen . Name of person making statement.
Personally Known OR Produced Identification Personally Known - OR Produced Identification
T pe of Identification Type f
Yo Identification
Pr duce — Pro ed_
(Signature of Notary
4+ n� RENEE PHILLIPPE , RENEE PHILLIPPE
Commission No. �P °• Notary PAI *ate of Florida Commission No. �' °°� Notary Publk$@MIJ of Florida
Commission#GG 179276 Commission#GG 179276
My comm.ex fres Mar.4 2022 M
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.5/6/20