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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED : -% S _(Aq DatePermit Number: I RECEIVER MAR 15 202� Building Permit Application Permitting Department Planning and Development Services i St. Lucie County Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: DAN)r L A fj I e-46,5014 Address: 501 0"1 I'lN %KF—F— DA )V t-� Er ► IF-84c . 3q qDL Property TaxlD#:������2- i;,S (�©i�• Site Plan Name: i Project Name: Iyr-W C4Y s T& u&T) p ' Cr3i?' akE-7E 51.,A a 83(a ,5 / x jcg q l w Jfi/f 57E-�:L. !3v)1.,D1AI &- 'll New Electrical Meter Second Electrical Meter Lot No. Block No. Additional work to be performed , under this permit - check all that apply:. Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors _ Pond1 Electric _Plumbing _Sprinklers _ Generator _ Roof ' Pitch' Total Sq. Ft of Construction: Sq. Sq. Ft. of First Floors Cost of Construction: $ 1 �lo Utilities: _Sewer _Septic Building.Height: NINE NEIN/ LUSSREE: C�� T ACTOR: Name Dj+MlrjL A Al OC. +0-5M Name: Address: 6,;t l% DRIVE— Company: - City: Pr' )SQ12-F,: Zip Code: 37!q Fax: Phone Ndt State: FL enn 7 L9 M Address: City: -State: Zip Coder Phone No E-Mail: _5A Q.'W/JtF©5 0'2 Mr. N,E% Fill in fee simple Title Holder on next page ( if different, from the Owner listed above) E-Mail 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. i NER/ENGINEER: _ Not Applicable 7am MORTGAGE COMPANY: Not Applicable : _ Name: ss: 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 such prohibit 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 lender o.r an attorney before commencing work or recording our Notice of Commencement. 0 Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA _ STATE OF FLORIDA COUNTY OF COUNTY OF Sto (or affirmed) and subscribed before me of P1 Sworn to (or affirmed) and subscribed before me of P ysical Presence or Online Not rization Physical Presence or Online Notarization this day of 200� by. this day of 20_ by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Ide Li#ieation L Type of Identification Produced Produced �� L (Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida ) Commission N( KAREN S. �SEiV Florida No Public Commission No. (Seal) =• •'c Commission # GG 207484 .y °ii ��° June 12, 2022 REVIEWS VISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW. REVIEW - REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev-75/15/20