HomeMy WebLinkAboutBuilding Permit Application All APPLI..C�ABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ` `-b a. Permit Number:
RECEIVED
O
° Building Permit Application APR 13 2021
Planning and Development Services rmittir:g Department
Building and Code Regulation Division Commercial, Residential It, Lucie County
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:
P -A dMid 'i
ROP„ E� ;R®a�� M= NT.L. : A
Address: (o f
Property Tax ID#: 41)- `" d`-OxVr 000 Lot No.
Site Plan Name: Block No.
Project Name:
e Q I RC,l nok L l I LD I nd GW uD F(11 AJ evOl I t2 CtcaC.O
I to'ctn(3
New Electrical Meter Second Electrical Meter
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:$ `� I ��� Utilities: —Sewer _Septic Building Height:
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�.'.7s"a ¢ Z�,�.ax�l4..>.,�.Lk,.7�3�33•��'`-�'�.. ..a _ '� � �.�� ,�� �� �.I?`Y�'3h'r�a rar. �.�, 4
Name 1 " Name:
Company:
City: fi j Nr)--Un SS State:�L Address:
Zip Code:-3q9 Fax: City: State:
Phone No. `�"] `J'� CI �� q Zip Code: Fax:
E-Mail: IS��rrl kh (,Zn CA,I C.Gn Phone No
Fill in fee simple Title Holder on next page (if different E-Mail
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$7,500 or more,a RECORDED Notice of Commencement is required.
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
ou.1902
0
p' Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 �.D� , M pn C1
PERMIT APPLICATION FOR: '__rPl,_5-reAK Cat CST
Address:_ 247 MO V-(i1 a l C'i y'
Property Tax ID#: � �� 1 3 Lot No.
Site Plan Name: Block No.
Project Name:
&6(6%►'M nk` U_)u4o•Wg C.�A ae-W
P AcA faTORm 5Y)yTJRQ '5
New Electrical Meter Second Electrical Meter
Oil
-
- t�J_Yts'Y+�¢=vT—'� Ls`a..WP.S-. L� la'" '.':£� Y' - - •3 t
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors _Pond
_Electric _Plumbing _Sprinklers ,Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ �,01TII " Utilities: _Sewer _Septic Building Height: 1
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CST® rP^�. },
iu;films^� LS8x2�a :iT-3P3'w"?.:Y.cti - -�• �m�-ssa aLW`Q"5'`c "S:-sz `� �^' Jtt:IRt4' � <.f,:.::d Faa33
Name IuTPw Co i Yt--r Name:__ MJEA SELF
Address: 2j�7 41AAINA II� Com'pany:
City:_j D'f kl o Sl1N fS State: i Address:
Zip Code: 1q Fax: City: . State:
Phone No. -772- %?l Zip Code: Fax:
E-Mail: 11Z\5-VRAD� 4 i H amdll•C00 Phone No
Fill in fee simple Title Holder on next page (if different E-Mail
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.
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: — Not Applica ble
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 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 lend r an attorney e commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5'N--. LZc'%k COUNTY OF
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed) and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
thi_s\3 day of_Ck� C i\l 202k by this day of 12020 by
cb�t S a 4IN <a\k�aC
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 �� d�L Produced
D
(Signature of Notary Pu -State of Florida ) S' nature of Notary Public-State of Florida )
Commission No. � l � DEANNAG1vEy5 o mission No. (Seal)
o"py'v `: Notary Public State of Fl 9
Commission HH 0823 2025
oF�` M COMM. tiona!Not ry Assn.REVIEWS FRONT IN, onde t►3r NS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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