HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �1 �� a Permit Number: a1ds���l�d
RECEIVED
MAY 11 2021
Building Permit Application PGrmittirg Department
St. Lucie County
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: S „� Mo
RROP®S`E® IMPROUE(V1E�NT ® /�(l®N" q.
_„ .,
Address: 3 o91, lk� V h0a 11,-e-rrcte 60
Property Tax ID#: /,(oZ a 7001 0 o I Ll 0 00 r Lot No. //�U
Site Plan Name: Block No. ''
T�
Project Name:
AERTAIIVERI®ESXRIPTI®N®F UV'®RK .�
W'ul
U-� S�abe
New Electrical Cleter Second Electrical Meter
C®NSTR�UCTI®(U�IN°F®R1111AT1®N� n r.
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q �� ' ��
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Wind /Doors Pond
Electric _Plumbing _Sprinklers _Generator Roof '3 ;1�\ Pitch
Total Sq. Ft of Construction: till`�7-Z Sq. Ft. of First Floor:
Cost of Construction: $ �� �o �• Utilities: —Sewer _Septic Building Height:_/
71,!WNER/LESSEE � oi
of—AM�� CONI"RACTOR:
Name 7o 5,ep,� We,I Name: 0
� .
Addres : O � �C �.s � R.
3 .2 l Com an . Pe � � �� v p y
City: ry �;2►Z State:rL Address:Vif A a� :e (e/ S' -
Zip Code: 3L/ 9,q(A Fax: City:J00i4 sY, ��� State:
Phone No. �7� i - y0 U/ Zip Code: 3 t Q 5 3 Fax:
E-Mail: \ 'WO- I 4b"1-7 rn; A,Cob7 Phone No 77A
Fill in fee simple Title Holder on next page (if different E-Mail k0y D("1VQgO@
from the Owner listed above) State or County License C C C 13 3 r 3 �
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
SUPPLEMENTAL CONSTIMCTI01 LIEN LAW INNRMATIC!?N:
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
improyk4ents to your property. A Notice of Commencement must be recorded in the public records of St.
Luc! u ty and po ed n the jobsite before he first inspectio . you intend to obtain financing, consult
wit len er or an orn befor encin work or rec r i ur Notic f ommencement.
47/_
Signa r of wne Lesse /Contractor as Agent for Owner Signature o ntrac r Li ense Holder
r �
STATE COUNTOY OFORIDA r — L���� COUNTY OFSTATE OF ORIDAs/ / J�
Savor c (or affirmed)and subscribed before me of Swor (or affirmed)and subscribed before me of
Phy,ggical Presence or Online Notarization Phy 'cal Presence or Online Notarization
this 4 tay, of tv a f, 202P by this /0fla_y of n 1 202 f-by
Name of person making statement. Name of pers n making state t.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public Signature of Notary PublVVVV
Notary Public Slate of Florift ( g Y
Apdrew G Reidy t7NS� Notery Public State of Florida
Commission No. eaHmission GG 347651 ommission No. And
r etdy
�� Expires p612312023 My C mm on GG 347851
law ���' Expires Q6I2312023
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
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COMPLETED
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