HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: A >12 1 Permit Number: ogz
RECEIVED
FEB - 3 2021
Building Permit Application Permitting Department
Planning and Development Services St. Lucie County
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: D(Wev, COinn-ed0on
Address: I 3 nRC1-�Rk Pa`M br ��" a�l"�rC� �(• �J Ig2
Property Tax ID#: Oc �- �O2""�u "-lJ��IJ-� Lot No. 3
Site Plan Name: Block No. 12'
Project Name:
U�C W-e CUJAI ng /C_0_ n nPch'Qr1 ff Orn our Vic.csfiYtG dr I yf wow
aQ.f �CiNA 5(:dL-0 , Vie. wak )m_ ►uskc -C� � Cor�car 2
New Electrical Meter Second Electrical Meter
1 �
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: ��yy�..��..�� Sq. Ft. of First Floor:
Cost of Construction: $ OCJ A Utilities: _Sewer _Septic Building Height:
NameW_( o be-to—on 3r • Name:
Address: 1Q _3 RsLQI ilm 1JY • Company:
City: - 1�1C� State: . Address:
Zip Code.'?m g.'Z- '-F.a�x:�Kou O uZ. City: State:
Phone No. 11a C60t`Jkk' Zip Code: Fax:
E-Mai1C6e,,(1CC,- • -FI0PS 0VQ(Jan .CQ(Y) Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
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: 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 an'd covenahts that r'nayrestrict 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[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 2County and posted on.theJobsite before t'he first irIspection. If you intend to obtain financing, consult
with lender or an attorh'e before commencing work or re`cordin ' our Notice df Commencerimb•nt.
i
ignature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 3 G,r Lr 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
this 3_nkay of t--0rLkRp 20_2A byI this day of 20_ by
M a,SI -b Lr-a4\-P1 2e- Qn U C
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification i,— Personally Known OR Produced Identification
Type of Id 'fication Type of Identification
Produce L-. Produced
ignature o Notary icrwd
& (Signature of NotSry`Oublic State of Florida )
JACK HEBERTCommission No. QMYgq�1lSSION#GG914867 Commission No. (Seal)
., EXPIRES:S`eptember19,2023 ,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION' SEA'TURTLE ; :MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW r REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6/20