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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Cd �Qj Permit Number: ecelVe© Building Permit Application 9aq.q � Planning and Development Services �2T Building and Code Regulation Division Commercial Residenti8hitting 2300 Virginia Avenue,Fort Pierce FL 34982 " `"c'E C'Uryty Phone: (772) 462-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR: w0© 'rGVO CT � ' 3' six. ..rx -. ar^ a' r �:. t W." `��,. '. 'S e.F..�s€ r �-ry .` '. ka.iA"s �" �,�K�� .,k. .s•: Address:m `1 Pro ert Tax ID#: 311) o O 1 �rr�� C,pO�� P Y Jam' L/� Lot No. Site Plan Name: Block No. Project Name: Y1QJCI� D�ITAl�EQxdCf �P�lt3itil C3F`1 /ORK f M� I cool k d1e�c A?ja' �n 1(l G VI WC> New Electrical Meter Second Electrical Meter 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: i,6 i(n4a—c Sq. Ft. of First Floor: Cost of Constructio —LW—Q-- Utilities: _Sewer _Septic Building Height: C? 1lNER/i.� EE_ C�fT aR .. r�_..,s:�,.. ... _..a::, __-.=:x;.. `z-_ ..,..�,.�i s�,�.`=x".._Y_. _.._..-c._.�v:n _- �..•;z.. ._...�� .. t� �?- ...,..�.�,�. -,r-,4�.-r� .r:r.as��.� �'s�.,,�_ Name Name: Address: r Company: icy/ b e 1 &e" — City: State: T Address: v� Zip Code: C(p►�{j� Fax: / 44pp('p($ = City: tC State: Phone No. '-�L 11 ( � Zip Co cc,, Fax: E-Mail: �l Mzsa) �1 ./rAn Pho o ��` yo/" Fill in fee simple Title Holder on next page ( if different E-Mail ` 1'� F►rG?i 111 from the Owner listed above) State or County Licensee 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. r EA 2g' .3- tv.:a s :t�`..: £ "lfs"sF.:. - ' b y e 'x > LENtN�'Ai .CtU€`T1( 7 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 a rney before &mmencingwork or recordin vour Notice of Commencement. Sign to wner essee/Contractor as Agent for Owner Si atur of Contractor/License Holder STATE OF FLORIDA S i �` � STATE COUNTY O LORIDA COUNTY OF l• Sworn to(or affirmed)and subscribed before me of Sworn to(or affir ed)and subs ibed before me of Physical Presence r Online Notarization Physical Prese ce or Online Notarization this day of ff 2024 by r this day of 2020 by Name of person making statement. Name of person makin sta ement. Personally Known OR Produced Identification Personally Known 0 Produced Identification Type of Identification Type of Identificad Produced r ( - %�/]L- Produced ' (Signature of Notary PuN -State.of Florida ) (Signature of tart'Pu ic-State o Florida ) Commission No. - eal) Commission `o-- -� Y B. Ukl:'HREY �r BY E L L E N V = ft9Y COMMISSIO, j GU 360817 Co orida-Not Public i r'` -=-' '` XPIRES:f2iarcfi 6,202 �l REVIEWS FRONT % M '(ry[71�{IJyG�[cJ� 1 2 00®� S VEGETAfTIoftl ° �5@A1 11lR�f E�nde. niU}A jGROVE COUNTER Ocf b E n2Ex irREVI,W REVIEW G(�G�7 REVIEW DATE . AUDREY B.HUPv1 HREY RECEIVED DATE EXPIRES:March ,2023 l' COMPLETED L