HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: T Z Permit Number:
UAKNE `
RECEIVED
- - Building Permit Application APR 0 9 2021
Planning and Development5ervices 1-armittiag Deaartmerr
Building and Code Regulation Division 5t. Lucie Cour,�,
2300 Virginia Avenue, Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE: _
Address: �� v g Ve 101 ✓I Cl--,� U P
Property Tax ID #: 1�l/I oG or�r� 6 ' VU -� Lot No.�_
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Site Plan Name: Block No.
Project Name:
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Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —\Nindows/Doors
Electric _Plumbing _Sprinklers _Generator —Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ .Gr) Utilities: —Sewer —Septic Building Height:
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Name
cipea
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Address: (� 2 S J2 fr ompany: i^0SS
_(: I .Address,- 1 y S S ( FX Yn clq� A
City:( State: I j r�
Zip Code:
Fax: " I'"City_ !o;cf .S7" /��c 1� State: J' "
Phone No. 2- 2 Zip Code": L/Is? Fax:
E-Mair-Fe4^, ,\ LL S IC CDv- aw` Phone No .�( S'� is Cava
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Fill in fee simple Title Holder on t page if different I E-Mail �k�r �ovr4s� � �r Q
from the Owner listed above) State or County License l7 0
If value of construction is$2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: T 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
swhich is in tructure.Pleasecconith sult w with applicable
rHome Owners Association e Owners tion and review bylaws
your deed for any and restrictions nts that which restrict
may apply.
such
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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOU NN ER OR AN ATTORNEY BEFORE RECORDING YOUR NOTI OF COMMENCEMENT."
Signature of Owner L ssee/Contractor as Agent for Owner Signature of Contractor/L •ense Holder
STATE OF FLOR19 STATE OF FLORIDA
COUNTY OF !' 1 - LIV Ct el COUNTY OF
The�aoing 7ii�A instrument was acknowledged before me The ffoy�oing instrument was acknowledged before me
this_tv,day of (-; 20� by this day of ZO 21 by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known 3'�_ OR Produced Identification
Type of Identifi ion Type of Identification
Produced Produced yan Sean Slattery
�otP Ass�o NOTARY'PUBLIC
Q
s
-STATE Oi FLORIDA
(Signature of Notary Public-State of Florida) ( gnat e of Notary Public tatty idE�pires 113012tl�x3
o,;gYPUB �ONJO N
Commission No.
_ � ea mrtnssion#GG13911 Commission No. 7070 (Seal) -
�; oe Expires September29,201
Bonded Tlvu Budget NOMY S
REVIEWS FRONT ZONING SUPERVISOR PLANS I VEGETATION. SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW 1 REVIEW' REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
.2/7/19