HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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d n ° 7Building 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: C��"" 1p�� �rKcr dr�i7G1 C, �l1�'���C/ C �L 2 %� Z
Property Tax ID #: 07 Ll 3q 160 t 160 T_? _00 0 ^5" Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
_� S
New Electrical Meter Z— Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
/► c,w a w,
Block No.
_Mechanical — Gas Tank M Gas Piping Shutters Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 4 2W 06 Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ,6i-Af e f ofVe- iyf !uit e In k0
Address::k2(0 lieu )Jye I/I✓V.riV
r4e:Co`rY�tdK�� � L?'rgA °_4140f &+ r
Company: uRi A? ,ra
City: Vivid %3t✓'o,(l.7 11 State%-
Zip Code: Fax: 7 7 Z 7 7 f> f9/
Phone No._-_7%L' 7 7
E-Mail: "l1'rr"rLt Cf Y Ct/-e , POf»
Address: 721 6a- ►tUq--
_
City: W1 h.4x State: f L
Zip Cade: 72�j O C Fax: 3 Z!�1f/`7 9 97
Phone No
E-MailC.0VV'01-qc_ N-ee-ra-0 VMA�L .Cow
State or County License__ /3 002
Fill in fee mple Title Holder on next page ( if different
from the Owner listed above)
It value of construction is 2500 or mare, a RECORDED Notice of Commencement is required.
It value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
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, wails, 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 yoy intend to obtain financing, consult
uji+h 1anr4ar nr an attrwnpv hofnrp rnmmPnring work or recordine vatFNotice of Commencement.
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Signature of Owner/ LZ e/ ntractor as Agent for Owner
Sig Pure of Contractor/License Holder
STATE OF FLORIDA /�
14Gy/!>h ye-
STATE OF FLORIDA
COUNTY OF /f l
COUNTY OF Fx, ar
Sw�to for affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
aI Presence or Online Notarization
Physical Presence or Online Notarization
this &dTo ay of /+-i' h 202P by
th s _Ll*-day of h&Ko.. 2024 by
w/1 VI?n
Name of person makingstatement.
Name of person making statement.
ers Po�n_ally Known �// OR Produced Identification
Personally Known OR Produced Identification
Type Identificatio
Type of Identification
of
Po�uced
Produced
(Signature of Notar P
(Signature f N a blic- te.g5 oriclaiPHLEY HELMS
.y� Natmry Public Stole a Fiaridt
Commission # GG 352735
ck
Commission No. yCd�ri , 'an
Commission No. �4 Qor 1":u9ust2,2023
OFF 8,�,�ed Thru Budget Nalsry Services
Expiros 1012112023
REVIEWS FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.5/6/20