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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED d� ) Date:3 ' A, ':)_ I Permit Number: RECEIVED lei MAR 18 2021 V B D - Building Permit Application perm Et' 9 Department Planning and Development Services ucie 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: �,.,� �C reraAUZ_. PROPOSED IMPROVE0 1 9M 10 LOCAT60N.. Address: `I� /Gc�/� d S : Cka Property Tax ID#: «��� �J &9o/— 00 0,-/2--� Lot No. Site Plan Name: . Block No. Project Name: D AILED DESC«RIPTION OF WORK: New Electrical Meter Second Electrical Meter CONSTRUCTION IN'FORMATIO : Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank —Gas Piping _Shutters _Wi,ndows/Doors _Pond Electric _Plumbing _Sprinklers _Generator` Roof Pitch Total Sq. Ft of Construction: ----so C? Sq. Ft. of First Floor: Cost of Construction:$ 6M. V Utilities: —Sewer —Septic Building Height: OW ER/LE�SSFE: ,/ CC1N RACTOR: Name .z�le_e /l) h Name: Address: 0;"7 .f TGv/ ,S _�r4_At Company: City: -E-• 'e!^C'e State: Address: Zip Code: 9�I Fax: �J City: State: Phone No. 7,o� 2/,9 / � Zip Code: Fax: E-Mail: E/ /t°e P1 A k L D t' fti�CI Phone No Fill in fee simple Title Holder on next page(i 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. SUPPLEMENTAL C•QNSTRUG THE ON Lf'EINS LAW INF©RMATI(�7N. 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 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 co encing work or recording our Notice of Commencement. Sign ture of Owner/Lessee/Contractdr as n or Owner Signature of Contractor/License Holder STATE OF FLORIDA a STATE OF FLORIDA COUNTY OF 1' COUNTY OF Swor 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 t ' day ofie,L 'by this day of 2020 by Name of person ��Cmt. Name of person making statement. Personally Kno n OR Produced Identifi�ion Personally Known OR Produced Identification Type of Identi tca ib n Type of Identification Produced L Produced (Signature of Notar # c- at ►prime - -,; (Signature of Notary Public-State of Florida ) t;nYNye`.. AUDREY B.HUMPI IR EY Commission No. �r�_, * M\'COMPot(3e�t! tC:G3S3817 'rz Commission No. (Seal) EXPIRES:March S,2P_3 rl 'rs'Q sic^ '.�lilru�ct�tPc.bi;c:!nds�wr:�=- � REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 5/6/20