HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 ` (5--'-' 2( Permit Number:
LL-)CLLM'
I_ ` `L ` L, tti 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
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 1360 7"" fs�' � �- 2A - -- ---
PropertyTax ID#: S`C" 5e 00_57X7 ^ 000"' Lot No.
Site Plan Name: iA0^ , i�� cr f'-c_Sf je^
c- c Block No.
Project Name: L-e- I d 4�^C_-_r_
DETAILED DESCRIPTION OF WORK: q
�.� t �� �r�a •' �T 2 M
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
—Mechanical _ Gas Tank —Gas Piping _ Shutters Windows/Doors
_ Electric Y Plumbing _ Sprinklers — Generator — Roof
-total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ (�, 'Z 6 Y . 5- 5 Utilities: —Sewer —Septic
Building Height:
Pond
Pitch
OWNERAESSEE:
CONTRACTOR:
Name J) ey-
Name: r4-1 5 cj-w�
Address: o rS - �A
Company: ' vA
City: z(-+- �-State:T�L
Address-32-i :5L=
Zip Code:,3Y°% Y�L _Fax:
City: Stater
Phone No. Lo ^ S0 a - f g i __
Zip Code:.3 q 62"11 Fax:
E-Mail:
Phone No2 7 Z [ "- 4-20-L
Fill in fee simple Title Holder on next page ( if different
E-Mail 4C-D
State or County License
from the Owner listed above)
L
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.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERANGINEER: mot Applicable MORTGAGE COMPANY: — of Applicable
F Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: ' Not Applicable
Name:_
Address:
City:
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 attornev before commencing work or recordine vour Notice of Commencempr►t_
Y
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature ontractor/License Holder
STATE OF FLOR DA
STATE OF FLORIDA
COUNTY OF_ _ -t-r�
COUNTY OF �✓�
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
11 Ph ical Presence or.. Online Notarization
-,,-Ph sical Presence or Online Notarization
this day of AJc&nJ , 202# by
this l day of 2024 by
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
re
(Sign uof ota t �,IiSSK # GO 274242
s'
(Signa# of Notary Pu "+ 1
'' •� f�[Y ION # GG 274212
Commission No. ;l ' :E•d�+�°,•, EXPIRi;"Navember25,2Q22
Bonde �aiaryPublicUruJerwftera
"m P-- EXP 25,202L
ommission No. t o•• Bonded �U„d m
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.