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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED i� Date: `�(-�l`41 Permit Number: V `qo 93r. LUCE OO 0� D 4 A -- 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 PERMIT APPLICATION FOR: a C Cho 45' e 0U'f' PRaP.OSED IMiPRO.UEMENT LOCATi3O,N• Address: 19 11 AV e- S 14,Ptercv, L 3 t +7 Property Tax ID#: V� �"I ��� Lot No. Site Plan Name: Block No. Project Name: D TA1LEa D F WOR uL(c( -'ON V4W4 10 K rVJ, la e&4 .Smwle 4e, avrlon S+aY%4 la A--r do.nAl2r'_ r ��' S Estcl� Lt4a Lirl FrP;k-r t� Y�ler Flbwi SWr�C`K New Electrical Meter Second Electrical Meter s CONSTRUCTIQ'N INFORMATION: Additional work to be performed under this permit-check all that apply: 5 V Mechanical _Gas Tank —Gas Piping _Shutters Windows/Doors _ Pond Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: (6Sa so Sq. Ft. of First Floor: Cost of Construction: $ 5�3 y'�. Utilities: —Sewer _Septic Building Height: ©11U�N ER/LE�SS�E. C:�NITRA_C�IT�®,R: Name_ Fre.ototf VIe-toY-IC" Name: uwt ytX�1 Address: l A 3, AVV- S Company: Ct-Iy L 60V VITt( A Sv fh C. City:- F-+. P % ert a State: EL Address: 5;1�0 N.W, N, L0\1nlf- CiY Zip Code: q 4ri Fax: City: p . S l., State:-L Phone No. rmx 4-6 y- ! -c xb Zip Code: 3! " Fax: E-Mail: Phone No 1717 x S. ( 1703' ' Fill in fee simple Title Holder on next page (if different E-Mail C(T`f COQVITI A%V* Q Crymo J, Co m from the Owner listed above) State or County License C Pp C. ( $( r7'1 35 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. SUN111:MENTAL C©NST tJ TI N LIEN LAW NFaFt�MATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State City: State: Zip: Phone I 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 Cou and posted on,the jobsite before the first inspection. If you intend to obtain financing, consult with lend r `r an attArney before commencing work'or recording o' r Notice of Commencement'. Signature of Owner/Lessee/Contractor as Agent for Owner Signature o tractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF LV`�'� COUNTY OF �y L 1= Sworn to(or affirmed) and subscribed before me of Sworn to(or affirmed) and subscribed before me of sical Presence or Online No arization Zay cal Presence or Online No rization this ay of 2021 by this of 2021 by 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 IdentificagQ 4 Produced V/� pxoduced (— Eli fp:m ature ° Y F (Signature of Notary Public-mate = tate'ot Florida-Not r N L EN VA Cta. Lary Publi �Ommission #�� 2 Public osState , � OF FlO A� ■'s�iAmitd�lorida-N tary'public (Seal) .,�Qmmission No. ".�� 270079 9'" al!MyQ�obese n x res 2 2 s "". October 22, MY Commissio , 2022 - Betober 22 2022 y M RE E Pie;,; . EfN �ry� SUPERVISOR PLANS VEGETATION SEA TURTLE :'.MANGROVE # o gY ° REVIEW REVIEW REVIEW REVIEW REVIEW DAT '%�oF��� Y ommissi xp n ires '''REC October 22, 2022, ' DATE COMPLETED ev.