HomeMy WebLinkAboutBuilding permit appl
i—
AII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a 8. Permit Number.
Building Permit Application; FEB B 9 2021
Planning and DevelopmentServices ST, Lucie County, Pem
Building and Code Regulation Division COnlrllefclal ReSlderltlal
2300 Virginia Avenue, Fort Pierce. FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address:
eD
Property Tax ID #: a K A�- a 41- o nv3- o 0 —9
Site Plan Name:
Project Name:
New electrical Meter Second Electrical Meter
Additional work to be performed under this permit— check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _
_Electric _Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: O Sq. Ft. of First Floor:
Lot
Block No.
-Windows/Doors . _ Pond;
i
_ Roof Pitch
Cost of Construction: $ 40 n nn Utilities: Sewer _Septic
I
Building Height:
"•'s-.1z+*-.3' 4n--S';."�2r.-.^=.�
A p..�'�..
l.lEtYCFI �'._s -;75�x."2```..,�x.n=a asp:
^.*"r_..:_..,-
Name
Address: 3 w3 '3' @
'Name:
Company:e
City: ft/ ple+a8 State: A'
Zip Code: 2Y Fax: 4
w-w•
Phone No. -7-7 X- f Is a- n;-7 D
Address: f
city: State:_
+v...su-•.y..y.wr.•u arar a*^•a-?
Zip Code: Fax:
Phone No
v
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail
State or County License
If value of construction is 7500 or more, a RECORDED Notice of Commencement is regwrea.
If value of HAVC is $7500 or more, a RECORDED Notice of Commencement is required.
Address:
City': State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:, Not Applicable
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name --
Address -
City: State:
Phone:
Address:
Zip:
COMPANY:
Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby mace to ooram a perms w UU Ulu WWI M u•— ••�-••--_.. __--._._____"
I certify that no work or installationhas commenced prior to the issuance. of a permit. ,
St. Lucie County makes no representation that is granting a permit will authorize-the.ppermit holderto 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 consultwith,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 1 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 concunency 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 recorcls of St..
Lucie County and posted on the jobsiite before the, first inspection.Ifyou"intend to obtain financing, consult
_m. ...a:....,,���r hint
of Cnmmencenient.
with lencie/r ora�n attorney Deer%ore LUnunctt�u, W`-Il
W• •I - -- - -
Contractor/License Holder
Signature of Owner essee/Con ctor as Agent for Owner
Signature of .
STATE OFFLORIDA.C1��C�
JJII
STATE OF C.OUNTYOFORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Swam to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or_onlin20Notariization
this day of 20�2 by
this _day of y
Name of person making statement.
Name of -person rimaking leme !--
Personally Known i / OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
of identification -
Produced
Produced
(Signature of Nota ublic-St
ignature of Notary Public -State of Florida)
D-thhhA GIVENS.
.- P�_aC - State of Flori
Commission No- 'A OE6� (Sg9
-a
1
'_ (Seal) -
mmission No.
YC •�` misslcr. id C85359
a
'
My Comm. E::ires.ar 21. 20
5
REVIEWS
FRONT ZONING
PLANS
VEGETATION -:,SEATURTCE
MANGROVE
REVIEW REVIEW
SUPERVISOR
COUNTER REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. S/b/GU