HomeMy WebLinkAboutBUILDING PERMIT APPLICATION_122 EASY ST._JOHN ANDERSON All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
21ro b�IC�DL
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: (-3, kD ,
PROPOSED IIUI:PR`OVEMENT LOCATION ;
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Address: l�i� i' �L�T - il'►�"� kl-t' �iL� f
Property Tax lD#: Lot No.6-7_
Site Plan Name: Block No. /J
Project Name:
D"ETA'LLE,D DESCRIPTION"OF
•
New Electrical Meter Second Electrical Meter
N'STR.UCTIio-N I NIFO'R,MATIIGN,-1.
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: Sq. Ft. of First Floor:
Cost of Construction: r G
$ �,�}CI� -G Utilities: _Sewer _Septic Building Height:
OINKER/LESSEE C0NTRACTOR,..
Name",,, Name: jc-vjo
Address: 1Z2 E Fa Si- . Company:
City: ; Y'_\.- State:L Address: )261 -5LO iIfGr�Cra
Zip Code: Fax: City: T�3( St ate:
Phone No. Zip Code:_ �;Qq rq 5 Fax:
E-Mail: Phone No --?' ?S, ) -`6`23-6Co0Q
Fill in fee simple Title Holder on next page(if different E-Mail % y4ef"O r '-sr-
from the Owner listed above) State or County License 0. AR to S 7
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.
SUPP-LEM:E,NTAL CONSTRUCTION iLF,EN L-A,W f,N°F.OR,'<AT'lQN
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.
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 attorney before commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/contractor as Agent for Owner Signat a of Contra or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF .ST C 4Gi e COUNTY OF S? Z uc:f•P
Swgrrrto(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization v�Physical Presence or Online Notarization
this�_day of_A42,c,L 2020 by this / day of dx gL/L —2G20-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
Produc d Produced
(S' ature of Notary Public-S Florid0 HUAS.ALSERICO'a (svrnuslo
of Notary Publicm,ftf gf FlodMIMPAS.ALBERICO
_ o Commission#HH 031950 Commission#HH 031950
Co mission No. �9 0� (t I+Js August 16,2024 Con No. `o� Exp(r5aWitist16,2024
�Ff� �ndedThruBudgetNotaryServlcas �FOFF�PP BMWO Thm B*et Notary Safts
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.