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HomeMy WebLinkAboutBuilding Permit Application s' L' All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: a�0�rd a31 S L�LL RECEIVED V. c ��' Building Permit Application. Planning and Development Services APR 0$ 2021 Building and Code Regulation Division Commercial Residential Pe mitt'r ill D27)arl' ent 2300 Virginia Avenue,Fort Pierce FL 34982 SL. Lucie County Phone: (772)462-1553 Fax:'(772)462-1578 PERMIT APPLICATION FOR: _e PROPOSED IMPROVEMENT LOCATION: Address: S"� � �'� �`��• � - �-- as Property Tax IDM oo\C15:)- Lot No. lIE5- Site Plan Name: Block No. Project Name: k � � 5oO ,scz DETAILED DESCRIPTION OF WORK: s /yeC New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: 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 11- Pitch Total Sq. Ft of Construction:—� �C� , Sq. Ft. of First Floor: c Cost of Construction:$ Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name 'E>le Gi -- -�--C� Address: I \-T cc--) u Company:-Ak i--C— city: Stater Address: 1dr2© �tJU -lam p Q 1. Zip Code: 3t�C� Fax: City: S Stater-- Phone No. Zip Code: Fax: E-Mail: Phone No-(' 9-�- Fill in fee simple Title Holder on next page(if different E-Mail s f .0 C�t�o-��r►c .�.c o� --� from the Owner listed above) State or 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. I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:, DESIGNER/ENGINEER: _ of Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLEHOLDER: _.,, IVot Applicable BONDING COMPANY: of 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 f Commencement. Signature of Owner/tess Contractor as Agent for Owner Signature of Contractor is nse Holder STATE OF FLORID �� STATE OF FLORID J o COUNTY OF7 L!� [ COUNTY OF_,- u Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of Ph ical Presence or Online Notarization Physical Presence or Online Notarization this Tday of Fl&O°P 2021'by this 1K day of 202p by e Name of person making state ent. Name of pe son making statement. Personally Known L-'- OR Produced Identification Personally Known ,►— OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary ublic-State of Florida ) (Signature of Nota c-StaIREORGitdAIti3 PO PEDRO M ALONSO ° Commission#GG 297802 Commission No._* ° Commissior(96Q97802 Commission No. CI � Ex ires February(Segp Pr o� j Expires Februar y 23,2023 ;ZFFjQO Bonded TWU Budget NotuySOMOOV trE oP i Bonded Thru Budget Nofe SeMom REVIEWS FRONT I ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW 'REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.