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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r L Date: Permit Number: I 0 � RECEIVED qa MAR 3 0 2021 Building Permit Application q permitting �partment Planning and Development Services St.Lucie Co 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: m t PROPOSED_I:MPROVEMENT::kOCATION Address: ,;3 D0 a Fo4 ?'2Lz PL `349g5 Property Tax I D#: `�3® 3 ' 6C� _ ®43 � _©d Q Lot No. Site Plan Name: Block No. Project Name: 'DETAILED DESCRIPTION OF,:WORK ` ►r ' + 1'�: 1 d- v:l Ck n &Lun -I0 1 ci eck-, a e" unx -. M f 2 n c� . n I � 1 cc�/17L P50 3u AJ4 Su New Electrical Meter Second Electrical Meter .. CO NSTRUCTION_]WORMATION :. W. 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 _I/Roof 3 L 'Pitch Total Sq.Ft of Construction: -z-%60 Sq.Ft.of First Floor: Cost of Construction:$ I Lf�6o®•0c) Utilities: —Sewer _Septic Building Height: 10 1 0�1 OWNER/LESSEE CONTRACTOR Name f1 ie- Zore- lck✓►c1_ Name: .J Address: Z1 S3 IDUA tw Company: d L `�%�- ?Wi%✓1S11 I- city: J�D�'� Ru-c . State:_ Address: I -8,3 5 IV C 0-4 t A✓e., Zip Code: 3LION 5 Fax: City: 0 l,�ter,hoebee- State:FL Phone No. Zip Code: 3'.cl7 Z Fax: E-Mail: Phone No '772 -R-91 -40-101 Fill in fee simple Title Holder on next page(if different E-Mail I � ACA-,.le- Pc04,r\5 5.5 r �t��►t. ��+ from the Owner listed above) State r 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 CONSTRUCTION LIEN LAW TN1=0RMATION .............. DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLEHOLDER: _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. 1 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 commencing wor ecording your Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature ract er STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S�i A� fI(�j � COUNTY OF 01Cp t e Swor o(or affirmed)and subscribed before me of Swo to(or affirmed)and subscribed before me of Physical Presence or Online Notarization Ph sisal Presence ar Online Notarization this j`7 day of M a_Pc f% 202G-by ^ this day of 1�2 �ftL'6'i 2020.by l 4t ? go 9r Name of person m=OR ent. Name of person making statement. Personally KnownProduced Identification Personally Known OR Produced Identification—Z Type of Identification - Type of Identification Produced P,1-- Oriy-ers -fcer sC, Produced Llilul.Se, (Signature of Notary Public-State o I r f Notary Public-S#te of Florid • =�. Put lic tate of Florida / Notary Public` to of Floada a ?rhorst Commission No. O � ? Eileen C Hag rmisslon o. d W My commissio HH 0 9 1 si HH 019411 /M C/f`'y// Yor a Expires onoa/2 24 0 24 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.516120