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HomeMy WebLinkAboutBuilding Permit Application All APPLICA L INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: I Z I Permit Number: RECEIVED ���CL UL o - JAN 0 7 2010 Q `° Building Permit Application permitting Department St. Lucie unty 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: W v \ o ,T.6 y .n.Cx"x kwxuC k 'ry" +�. N C !., " xarc1P':rc'! i1 ...dry.. �S,!k !xa v-v..ak, k! 3� va�.Kvkxvxxxxeu vai * ., , �., ;3 a;.ax.:va .a.� r�: .?.x... xxxx"x.xx g� k ,. ,3� (�+y} 3x1. r ��ikt: aw. x rc �# rcc Ka xx.x -"l�C �? ` ,,4x C xa.xx 3t .nary a,C C A xG:: C i... ° °t. . Address: Sly® 1�L ii 1 Property Tax ID#: 8� , �� 1 —y �� �C `�� Lot No. Site Plan Name: C Block No. Project�Namer— �A<< OL: ) LnG Lk,c _j oe,-,, q9 C6 s v."�aa ...vi�x..xxxx axxxxxS x x.xx fee vx"ykk S'� .,.'{ ,q v�<,.� PG q E xxd., . x3a�.�x..x x.axx ..a .:.. _...._ ...� � LAX�s i�3�0u�5 .—�► al( x�� �� � q- �"��� 1j Ij New Electrical Meter Second Electrical Meter tja {v. xx-vxa v,x xw, q u:xxxryxxvx.xxx_xxs {v!.! ssxgxxrc,xryrclxss uy � '.. Z2, v vryx:v rya S a�a.�awvvx:lxx.xav ..3'v.. xxkkxv� ... x vv r.ax..rya Xx A : l .ax tl S x_,xxwx.:xx...xa3 xwa 9.c Ak.a xwxk xkxxx xxxxx.xx. .:••x ,,a„ ,.3 ..,1 a awnaaa...xx.WE .C x. a ... �..`xx; x �i:vkx.,xx,xxnxx.xx xwa ..a:.x.xx �. . as.ax xa...;:,",.. e ck s ca 3 aff xx:...kx9a.,s s E �zx fir, s t gC 'C3 i k e lx 9 ,. �a, ' 33i k � � 14I Ft� `f E7l� 3i s tig x a q 1a i i haxrcx�a .._... �. ...a,.. .x .::4. ..a axCv Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank —Gas Piping _Shutters windows/Doors _ Pond Electric _Plumbing r( _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: �P Sq. Ft. of First Floor: '0 Cj Cost of Construction: o Utilities: —Sewer _Septic Building Height: 3>< ma a a, .u e3c a 3 e 3t &3k x.3:. �1 as 1a aa::3' i ':1._.axx.xGpa. c uw..x. a' ka ,3Z`! 9 r Ga ,i 3iF i�:xk E x..F u3 AC].a xxxxan3p b w vaax It ..Iix�a"ax":"axara s�� ak .kx:xx:z:... ;»a,i .3',. �, �C 4 r � s �,xxxx,kxxx 'ax�..rv�xxxxxxx•aY .n v N �.,..axxa.x� Sx xw.:axxam xxx, xxx.aax.xvxx.xx:.xaN' i.aa..!..xa.�".g9 xa_xxx>kys3.3u� +Fr.. :t:. C 3.. y ,: C gg 3axxRpp::a 3ll�� .. ._rcW_.._. ....YR ........_@..._._ G['i ._..3 Ski ._..d^ ..... ...ve va C4 i FPS.FeYYxx b. Name IA. A -L Name '5 Address: ©o 'V I i\JJ Company: Isi ot'J City: c 41 � (aUc,C State:L Address: �-AM.- Zip Code: j g� Fax: �S �7�3c�`�1O City: SaP, State�L Phone No. 22a 4"1 Zip Code: �SAWy1= Fax:79-4Iw� E-Maii._ ►JZ.r ML7-�V\ng',g6 C YA X-�0 ,Co0 Phone No 1 ( 4'y Fill in fee simple Title Holder on next page(if different E-Mail 75.A,U,P 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. ...... -,- k S .Y4'Sj`'s �`'K.k..`o•.'•>�:R� z"#' Aft .:�Zxz:: y `��3k '� Y g m� & x ' rx ' .. . . .»». DESIGNER/ENGINEER: i , 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 to your property. A Notice of Commencement must be recorded in the public records of St. u ie County and p sted on the jobsite before the first inspection. If you intend to obtain financing, consult twit1h lender or an morney,before commencing work or recording our Notice of Commencement. Si ture of Owner/Le ac gent for Owner Signature of Contractor/License Holder S TE OF FLORIDA STATE OF FLORIDA COUNTY OFF• k,lUWL, COUNTY OF Svyorn to(or affirmed)and subscribed before me of Sworn to for affirmed)and subscribed before me of J� P slcal Pr ce or Online Notarization Physical Presence or Online Notarization this day of 2020 by this day of 2020 by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification y Personally Known OR Produced Identification Type of Ide icatio Type of Identification Produced �[ ( � l]!111'�tJ�S "V�'.(/1 _,L Produced (Signature of Notary Public-S to q ��Pori a LISA M.CAUDULLO ( ignature of Notary Public-State of Florida) / Notary Public-State of Floriiia Commission No.C7C'J5Lf (SeSi,mission e GG 360576 C mmission No. (Seal) My Comm.Ex,-fires Sep 25.2023 Boneec through Nationa:Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 5/6/20