HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:1A do a. Permit Number:
RECEIVED
Building Permit Application APR 09 2021
Planning and Development Services Permitting Department
St. Lucie Courrt;i
Building and Code Regulation Division �[
2300 Virginia Avenue, Fort Pierce FL 34982 Residential
Phone: (772)462-1553 Fax: (772)462-1578 Commercial
PERMIT TYPE
UM
Address:
Property Tax ID#: �
.. �p �e� 3l1 10(343 Lot No.
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 Windows/Doors
_Electric _Plumbing —Sprinklers _Generator ;j_Roof..:
Pitch
�� S . Ft. of First Floor: I�
Total S q
To . Ft of Con
struction: T q
i 32 O60 p�& Utilities: Sewer Septic Building Height: I`('�SFj
Cost of Construction: $ - — —
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Name �/ �byJ�t�Y Name:
Address: � l,5 Company;
City: State: I Address: .
Cit
Zip Code: 3Cf 1 S Fax: Y
�IV S 1 ' x:
Phone No. � 5� .Zip Code:
i
E-Mail: dYIGt l�. C.unA Phone No
Fill in fee simple Title Holder on ne page( if different E-Mail
from the Owner listed above) State or Co ty License
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: _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
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict orpprohibit 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„perforEn 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 YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
I **Signure of Lessee/Contractor a gent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 14: day of A C�N ,201b.1 by this_day of 20_ by
O.A,r\ DOS-A--it—AA
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
Produced Produced
(Signature of Notary )u i (Signature of Notary Public-State of Florida )
;.• v'v�B�.: DEANNA GIVENS
Commission No. NQt;ftP)ublic-State of Florida Commission No. (Seal)
o€ Commission#HH 086359
''•..,,oc c�°'` My Comm.Expires Jan 28,2025
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW I REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19