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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date Planning and Development Services Permit Number: Building Permit Application Building and Code Regulation Division Commercial 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: Address: 182 IJ\/J &-n-0AD(Xk CLit Property Tax ►D #: LM-L- P©Z —poll --ppp - q Residential "/ Lot No. Site Plan Name: Block No. Project Name:Ge- JI �e goo� DETAILED DESCRIPTION OF WORK: New Electrical Meter Second Electrical Meter I CONSTRUCTION INFORMATION: I Additional work to be performed under this permit- check all that apply: _,Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Pond _ Electric _ Plumbing _ Sprinklers Total Sq. Ft of Construction: _ Generator /Roof `S Z Pitch Sq. Ft. of First Floor: Cost of Construction: S .0 s Q • Utilities: _ Sewer _ Septic Building Height: 110 I OWNER/LESSEE: CONTRACTOR: Name lC p*ogi [- Name: �iRTlluP_ p Address: li`a % IL J % J auTran bt" 12 Company: ® ELA City: t �tlarrt Cd State: _ Zip Code: 1^0 Fax: Phone No. 150% E-Mail: 111AUW r 5 Address: p�8 City: 1 .I • 6 State: EL Zip Code: 334 It Fax: Phone No (''•��{ '.55`fr Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail gdw,40,yl(I 69 State or County License (4C 0 Zq • -ca•wv v• a.vna��4bUV11 1J GJYV V, mwe, a rctL.VKuru IVOilce OTt.ommencement is required. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: _ Name: Address: Address: City: State: City: Zip: Phone State: 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 bylaws rules, 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 leinderoran attorney before commencing work or record' our Notice of Commencement. Signa re of Owner/ Lessee/Contractor as Agent for Owner Signat re of Contractor/License Holder STATE OF FLORID ,/� n 'b STATE OF FLORIDq /� �� COUNTY OF ( a&c'k COUNTY OF� �NdQ yet Sw9+ n to (or affirmed) and subscribed before me of Swn to (or affirmed) and subscribed before me of V Physical Presence or Online Notarization this 2. day of Ivi 2021 by Physical Prese ce or Online Notarization _ — , this � day of 2021 by Name of person makingstatement. Name of person making statement. Personally Known d/OR Produced Identification Personally Known V"" OR Produced Identification Type of Identification Type of Identification Produced t Produced (Signature of Notary Public- State of Florida) (Signature Of Notary Public- t�of Florida ) Commission No.&G"4103 Notary Public State of f sion No. C<s C( �� „7 Notary �.►x�"4� Marianne G Scheri orida �mtis�`' Public S Marianne G $ to REVIEWS FRONT xpires0411912024 P VEGETATION 1110f Expires 041, S/20 r SEA TU 4 COUNTER REVIEW REVIEW REVI W REVIEW REVIEW REVI DATE RECEIVED DATE COMPLETED ev. '9563