HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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L' Building Permit Application
Planning and Development Services
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Building and Code Regulation Division Commercial Residential
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2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 40 SC 41gnyL Or>F �� �.yaiC
Property Tax ID #: 3419' 5'30 • 00 q L - 6O0 - 7
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Lot No. 7 �
Site Plan Name: 1417 S E at
Block No.
Project Name: r4q, o
DETAILED DESCRIPTION OF WORK:
M we ar 4 c ta. V A w, 4A M og / h td
bl 0--tw
r'>hoYA ul Otf v►-il AL Z101 00_79 C4G EL s`
• 9-L9
New Electrical Meter Second Electrical Meter
CONSTRUCTION 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: 571 Sq. Ft. of First Floor:
Cost of Construction: $ ZsSeo - &P Y Utilities: _ Sewer _ Septic Building Height:
I OWNER/LESSEE: CONTRACTOR:
Name 1 0 io/La.k Name: Johns-4-him Rnssftr
ff
Address q11 S % ✓tte ot. Company: s C' n
City: 51. State: Address: ZY0 Cw
Zip Code: If91 3 Fax: City: 1)t Lan. Stater
Phone No. '17Z - 971 - & 35 Zip Code: 327 Z 4 Fax:
E-mail: $ ll#-Jq r ,2 4& (ep Q.o f • C Orn Phone No 3 (p (iZ % Zo`t I.
Fill in fee simple Title Holder on next page ( if different E-MaiIPe.irM i is #V 0Ss tr fwa 4 A4 , t* '^
from the Owner listed above) State or County License C ee I $,3 / q !L
11 Vd1UC UI CUnSirUCLlon Is LJuu 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 CONSTRUCTION LIEN LAW INFORMATION_
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phcmo ,
DESi XERyENGINEER - _ \.. A ;
A dress: -
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
Not Applit .tl1lc
BONDING COMPANY: Not Applicable
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 indicate&
certify that no work or installation has commenced prior to the issuance of a perm it.
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St. Lucie County makes no representation that is granting a permit will authorizebthe
I nd permit
holds than build the subject
proit structure ch
%Wch is in conff�ct with any applicable Home Owners Assxiation rules, y y
structure. Mease consult with your Home Owners Association and review your deed for any restrictions which may apply.
'n con-<deration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
n 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 rion-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 ttorne before commencin work or recording Your N ice of Commencement.
Sigrature of 04anrDA��,
e, o tractor as Agent for Owner Signature of Contra r/License HolderSTATEOFFLO STATE OF FLOR ACOUNTY OF jO#JSt 0— COUNTY OF 0105i0'.
Sworn to (or affirmed) and subscribed before me of
Y Physical Presence or Online Notarization
this jk#-day ofVj&Z A 2021 by
1 A G A. "A.. Pit C v e
Name of person making statement.
Personally Known )_ OR Produced Identification
Type of Identification
Produced AJ14
of Noiary Public- State of F
Commission No. �}f riyi
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Sworn to (or affirmed) and subscribed before me of
t' Physical Presence or Online Notarization
this Il. "May of 1 l"C-h 2024 by
2oit u
Name of person making statement.
Personally Known )— OR Produced Identification
Type of Identif cation
Produced N1A-
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Jarrll ture of Notary Public- State of FI
Comm.#HHO 7481
EViIIa: .C�n2024on No.1JW NIA r
Bonded Thru ron Notary
Comm.#H 6748'
:xNo 29
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Bonded Tlxu ron Na
SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
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