HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0 2 0 2 ( Permit Number:
91To LUC E
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
IPERMIT APPLICATION FOR:
$OPOSED I' ROVE- ' ENT LOCATION:,
Address: 3 o I cCe-c A ve Et: e &
P'Ioperty Tax ID#: 3 q0 9 - go `f - on o 2 QO O - Co Lot No. 2
Site Plan Name: Block No.
PiojectName: ��o/�o,Q �, S'� Ct-PC(�
'DEg:TAILEpDESaCRIPTION^OF
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art v, (c/ e ur`�c 1� 6 �ee D S-F-o r d-q,�° ,rLc a c0
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New Electrical Meter Second Electrical Meter
CO;NSTR'UCTI:ON INFORMATION `
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: Sq. Ft. of First Floor: / 64
ColstofConstruction: $ Z 37S Utilities: —Sewer —Septic Building Height: Pte
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OWNER/LESSEE ar; CONTRACTOR {
€, .
Name _�Q �.� p ( 'Act le rry Name:
Address: o dee r A c-le Company:
City: State: FL Address:
Zip Code:3`f 9 8 Z Fax: City: State:
Phone No. FScil - cfc.( --�ZS / Zip Code: Fax:
EiMail: dC6L I Q A4.a-4'1. c c 4^, Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
f ri
om the Owner listed above) State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If i lue of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
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�SUP$PLEMENTALCONSpTRUCTION LIEiN LAW INFORMATI N fi
-nt;.`S�h:a�,`aL"�'--ke ..�.�,.,.«. .-- _�,m, T°�;.<a.� 5fa.Y'`u,.�.n] t�` `� '• .. ..�, _"
DESIGNER/ENGINEER: -Not Applicable MORTGAGE COMPANY: LNot Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable BONDING COMPANY: _g:�,Wbt 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.
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
Taccordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
T1he following building permit applications are exempt from undergoing a full concurrency review:room additions,
alccessory 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 commencing work or recording our Notice of Commencement.
0-01
Signature of Owner/Less /Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
X Physical Presence or Online Notarization Physical Presence or Online Notarization
thiJ4& day of ftve,eA 2024, by this day of 2020 by
�Em2caE G. S �f Fc/L
Name of person making statement. Name of person making statement.
Personally Known_ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
c'' LORILYNN GREGORY
(Signatur f Notary Publ Qf �(� c rate o on a (Signature of Notary Public-State of Florida)
G?s ommi lion N GG 920586
n /1 C, of My Comm.Expires Oct 13,2023
Commission NO.ti- / O thr(�t�1Wonal Notary Assn. Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.