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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: .µ k, Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772Y462-1518 PERMIT APPLICATION FOR: X- fi i s�v�z«'` �" a%;""c�� ... `:N , mar' w U o s}n� xa... . 7 ,. .?�, c a,.,-na, �,e...•-Na, .. _.;gym a." >,,.r�m _ — Address: - 10co 7 \v-�Ii,1 Property Tax ID #: Z34- Lot No. Site Plan Name: Block No. Project Name: Y 6u C­zi ySC C RM ^�.f.�',��-.?y"��, `kv..�`"f ..._ ''"�-a"r'ey :.�"_"�rk..''^� ..-f. '+` 5�.'S'sa'•,�'°A+,t.�`a'e�i. f<.,_i,;'_..K' '€ tr New electrical Meter Second Electrical Metera6 q Na xcti*;1j-«'1 �„�,d"'-`:,-i`,, y —.;..h 1 'x# f x z. , v'"3 F'ax E ". T,�' `x%�.f `�'..�"t ,--:� w 'Lr•...L�F ^��C �Y "a-i�� a�., r'L'•�''�y`,i�`""ra"''� r �,f....; s=•iz.zhA,,. :- y, r, ra� `.. rtm s�,n'3�-� is`% N, ''' 'a''.'` rii`E.:.%^.. Additional work to be performed under this permit- check all that apply: XMechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors — Pond XElectric( Plumbing _ Sprinklers _ Generator Roof Pitch Total Sq. Ft of Construction: Z6-6S Sq. Ft. of First Floor: Cost of Construction: $ Z10 006 is Utilities: _Sewer Septic Building Height: 'y,ii�, ° u� `h mi� Ab Y t t: ' +i,� s Aii �,u q a*,;.„�.�'x �.','��yj e y,.i`,`3- t. t 4 9M31� `�Y�'. X.e �P,, 2, :° 5 x3S�"3�,s, •�, 3% ' M' y,0L �y,'%,' 'C,4`'_ +a^°k, i ,r r• •'£ d_^^v;�"� r `^` � 'k- � a d.l `F.•,. ae .g5,a ;r k 5. , e�w � "Y:1, ....ex , ..�a.,,,F �P, ' i,k «"::Z :� ix_> ,`- s�._ �. ter.. 5" . �. .. ,. . IN •Name.,, � fp'<���,2�%D �°'��:��40 �C, ��� s:�„Name .�., f:' 1�c�i�, �I-.A`t�nnc3�c�1J 7. Address:' I l`(goa ''"ram I� C� nti - �� 'AddreVA.ss: Zip `cJt`�N,�6iG� _ �: LA City: �-\ �k <. State: 1Z�J Zip Code: Jq 9 11,5--Fax: City: State: 1 Phone No. Z-01- -21584 Zip Code:_ ZLqul . Fax: E-Mail: Phone No T1L-2 �b' I1�3�s Z2Z-828 ( Fill in fee simple. Title Holder on next page ( if different E-M ail 1Z1�`�����c� zq from the Owner listed above) State or County License 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: _ Not Applicable MORTGAGE COMPANY: Not Applicable., Name: 0A ke l A Name Address: 43b Sc M M-ZANTA -AOi; Address: City:T-, Luc, 6 State: Z— City: State: Zip: Phone ?7Z- 871 =2_4i57 Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable Name: Address: City: Zip. Phone: BONDING COMPANY: Name: Address: City: Zip: Phone; Applicable OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I'certifythat no work or,installation has commenced prior to the issuance ofa permit. St. Lucie County makes no representation that is granting a permit will' a dthorize the permit holderto build the subject structure' which is in conflict with any app.licable 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. Inconsideration 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 a posted on the jobsite before the first inspection. If you inte d to obtain financing, consult with lender ,a ornev before commencinia work or re in o otce mencement. igna ur�`erof7ew`"ner'/ essee/Contractor . /-Agent for Owner Signature of Contracto /Li nse Holder . STATE OF FL ) C UNTY OF STATE OF ��U.`�� COUNTY OF I �` orn to. (or affirmed) and subscribed before me of w to (or affirmed) and subscribed before me of fP%�(�iical Pr Bence or Online Notarization this7y yiay of 20&1© by hysical Pre ence o pia o. Online Notarization 20 by �0 L Name of person making statement. Name of person makk st t ent. . Personally. Known OR Produced Identification Personally Known Type (dent tion OR Produced Identification Type of Identificat n of P uced uce ;• TuC BARBRA AGOODWW kul�L GO 1984 83 ture of Notary Pu\ State 'ate) . Cananisslon GG1981 rE*w March 20,20 3 (Signature of Notary'Public- )Match20,2022 tateVIP' lboBue "Mot Commission No.&-& \ � �o�N eal tbaeadgei"ry commission N . �aod�dy (Seal). REVIEWS FRONT ZONING SUPERVISOR PLANS' VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 5/b/ZU