HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE
Date: �• '8 -- RtEC
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APR '21 2021
Department
Building Permit AWNCounty, FL.
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)4.62-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
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Address: lo--3 onorlo
Property Tax I D#: D ' �� � (� _ Lot No.
Site Plan Name: Block No.
Project Name:
71-E" .`.%dam +. id �`P'y'dun'k'il'.� �.LS,� t' T:t' rt "`
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New electrical Meter Second Electrical Meter
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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: C? Sq. Ft. of First Floor:
Cost of Construction:$ �(� Utilities: _Sewer ,_Septic Building Height:
Name ' u _ Name: OW nk —
Address: (0013 1 vo .( Company:
City: )vla State: Address:
Zip Code: Fax:��"" City: State:
Phone N3 uI Zip Code: Fax:
' E-Mail• c /►I P A or1'1 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 Applicable
Name: Name:
Address: Address:
City: 'iState: City: State:
I 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 pehriit to do the work and installation as indicated.
.I certify that no work or installation has commenced prior to the issuance.of a permit.
j St.Lucie County makes no representation that is.granting a permit will authorize the permit holderto 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 consultwnh•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 wili,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 recorcls of St.,
'Lucie County and posted. 'an the,jobsite.before:the first inspection.'lf you intend to obtain financing, consult
with lender or an attorneV before commencen work or recordin our Notice of Commencement.
gnatur Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder .
STATE OF FLORIDA_ STATE OF FLORIDA
COUNTY OF COUNTY OF
Swo�rr io(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Ph sical Pres nce or Online Notarization, Physical Presence or Online Notarization
this�day of ' 20 by this day of 20, by-
,LoukRer� Jahn N.
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-
it
(Signature of No ry Public-State of Florida . (Signature of Notary Public-State of Florida)
t}SYP 6 AUDREY Ua 'HREY I.
Commission No. Il =o- ••,t My OMM1S � GG340817 Commission No. .(Seal)
1tho; EXPIRES:March 6,2023
REVIEWS `FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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