HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED 'FOR APPLICATION To BE ACCEPTED
Date: Permit Number:
liRECEIVED
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: MAR 19 2021
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Building Permit Application Permitting Dapartment
Planning and Development services
St. Lucie Courrty
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: coricizet 9ir0VAqrfVA1 7,10, C,0M#4Vff- &r1ftC&Jf
Address: 9V N. &&AIA X "
Property Tax lD#: lifll— 74-,j--' 900gi- Lot No.
Site Plan Name: OUAA/ AIAK
Block No.
Project Name:
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATIQ
71
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: Sq. Ft. of First Floor:
Cost of Construction: $ llraaa. -oo Utilities: —Sewer —Septic Building Height:CONTRA _
OWNER/LESSEE `
177 7-7777=7- 7
Name:
AddressJr35— zc-> Company: SlAuc.,rolle Cog'
State: FG Address: O. 26 UP
Zip Code: 32%0 Fax: City: State: rL—
Phone No. 77 Z 9 - 1? gjr.? Zip Code:
e. It 40 C,1 —1"73 .— Fax:
E-Mail: i di
ha&&eo-ITI, —COM Phone No - 772 216e431
Fill in fee simple Title Holder on next page ( if different E-Mail 5-4fu,40 e- C. on 0 410 !!�Orh
from the Owner listed above) I state or County License -Akt.C6C 061033
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.
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DESIGNER/ENGINEER: _Not Applicable
MORTGAGE COMPANY: Not Applicable
_
Name:
Address: e�3o AvE
Address:
City: Ea State:
City: State:
Zip: ��2q� o Phone - z S6f IZ_r7
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY:- Applicable
Name:
_Not
Name:
Address:
Address:
City:
City:
Zip: Phone:
A•A/w•�w / s
Zip: Phone:
vvV 1Vr-R1 L-vIv 1 it AL. I UK APPIUV 11: 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 attornp_V hpfnrp rnmmonrina le/nrir nr rornrriin M-44— _.0
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF. S% /i/Gr R
COUNTY OF_
Swor,p to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Swor to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of &M"4 202,0 by
this _111j� day of /'J , 202j1 by
661e Ap.ss UVA&CX
,Pow. -ems
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
(Signature of Notary Pu c- o �+
NW1i�ic state of Florida
(Signatu a otary Pu
• Shannon O'Donnell
Commission No. My C�a� Aston GG 2as323
Expirbef1312022
Notary Public State of Florida
Shannr�nnell
Commission No.My
R
Co GG 248323
Expirer• R8113/2022
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