HomeMy WebLinkAboutBUILDING PERMIT APP (1) (1)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
i L✓M-:
v.
`r 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: (772) 462-1578
PERMIT APPLICATION FOR: S,w)\--
PROPOSED IMPROVEMENT LOCATION: J
rlrl.acc. C �4 N1 S i L
Property Tax ID#: c�y oI l a- - O�� - 000-L Lot No.
Site Plan Name: (3�3'i ' aCSC (05°'46Block No.
Project Name:
DETAILED DESCRIPTION OF WORK: Q
.OVKi,n , rS Z 1 q _� Lr, I I Irr, wt i
New Electrical Meter ✓ Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
L—Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
VEtectric �._tgmbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: t I dla- Sq. Ft. of First Floor: 1, 01
Cost of Construction: $ � O�j� ppc� Utilities: _ Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name l
Name: ::S_ak,-\_ A. %w-u�
Address: S09
Company: Gyyla_ Rwj __S -Tv�
City: Stater_.
Zip Code: 3�g y:1 Fax:
Phone No.
Address: 51 l SW PSL �t
City: Pw -�- &_ l_� e'_ State: 1�_-L_
Zip Code: 3qc S3 Fax:
Phone No—l1L, 3-
�Uc -7U53
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail 1 D OLU I AtfS .
State or Cour4 License C &C• 15-z4 13N
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
Name: 0^r1S &_CrS
MORTGAGE COMPANY: _Not Applicable
Name:
Address:51oq G-rw•.d.
Address:
City: ork'V\cv \— State
City: State:
Zip: ,3,Aaa,0k 1 Phone 1 -UQa ,01-6
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 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 cpmm_encing work or recording our Notice of Commencement.
Signatu of Owner/ Lessee/Coriyactor as lent for Owner
Sign ure of Contract r Licens eyder
STATE OF FLORID_A-1 (( �� �
COUNTY OF `�[ IJu. e_,
STATE OF FLORIDA rr .�,�
COUNTY OF '4, LtkcA
Sw rn to (or affirmed) and subscribed before me of
sical Pre ce or Online Notarization
thiP day of , 2024 by
S or to (or affirmed) and subscribed before me of
hysical Presence or Online Notarization
this day of 12020 by
p'hon
S'b\L
Name of person making statement.
Name of person making statement.
Personally Known V11 OR Produced Identification
Personally Known _ OR Produced Identification
Type of Identification
Type of Identification
P oduced
Produced
ature of Not y Public- State of Flori )
ANG►E FINL
To mission No.C�U �i5 �'� , �) MY0001SS1oN#
2 E(pIRES: NovembhruNotWPub1I
(Signature Uf Notary Public- St
ANGIE FINLEY
Commission No. %a��MMISSION#GG356
ES: November 17, 2
• P OF �.`
REVIEWS
FRONT ZONING
COUNTER REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEAT
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.