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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO`MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:. Permit Number: D,� 1 © � � 0 RECEIVED Building Permit Application APR 16 2021 Planning and Development Services rarmit hag epartment Building and Code Regulation Division Commercial Residential s, "county 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR: PROPOSED,IMPROVEMENT LOCATION„ .A. Address: :7 0 2_ &✓I S Property Tax ID# I Lot No. Site Plan Name: Block No. Project'Name: DETAILED.DESCRIPTION OF WORK &✓Kgpe-,�_ 1L/ooj eiv4,`I .. ej P- IS' , New Electrical Meter Second Electrical Meter CONSTRUCTION WORMATION. = 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 '. Z- Pitch total Sq. Ft-of Constructio : 19 00 Sq. Ft. of First Floor: Cost of Construction:$ 9100, 00 Utilities: _Sewer _Septic Building Height: DWNE;RAESSEE :.CONTRACTOR: } 1. Name Gal ff Name: Address: -7Oo2 eAen R6 Company: ' �SCo' 9iO4e epgr City: �- r. Q ��� State:��- Address: N Sty en Zip Code: 'S'-Lg S Fax: City: Pq m Ci Stater Phone No. `7-72 .rj 0%"00 C�I Zip Code:3 Lq,cW Fax: E-Mail: Phone No —77 Z-- A ! _ 25c3c( Fill in fee simple Title Holder on next page(if different nStatei from the Owner.listed above) r County License eCL I 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. SI�PPLENIENTaL' CONSTft_UCTION LIfN LAW INFORMATION DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable 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 lender or an attorney before commencing work or recording our Notice of Commencement. 'gna ure Of Owner/Lessee/C for as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF -ST �_Ut✓ COUNTY OF S 7 UC I t Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of ,x Physical Presence or Online Notarization __2< Physical Presence or Online Notarization .this /,6 day of 14 PPI — .2G26 by this j-&_day of QPPI 1,- 262& by I 2021law Name of person making statement. Name of perso�ng statement. Personally Known OR Produced Identification Personally Known OR Produced Identification _ Type of Identification Type of Identification Produced ELo(rdcc j?rlyers icv_nse Produced FlorrdQ Orrver-s / t arse r l/1ct�dAnU(e , flr 61.Qc (Signature of Notary Pub !State of Florida) (Signature of Notary Publ -State of Florida( g ry ) fy e a Public State of Flon �. oVaY'ej� f�ubhc State of Florida Commission No. �I ? 'SOAlee C Hagerhorst Co mission No. �D / o �1C Hag�rhorst r1' �,� My Commission HH 019411 v My Commission HH 019411 ? :�'•Loa Expires 07/08/2024 '�? o�A Expires 07/08/2624 tit/•.. ' '.•J0✓�JL REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.