HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 6631
s too LUC E E
Q RECEIVED
Building Permit Application MAY 20 7071
Planning and Development Services
aers�t
Building and Code Regulation Division Commercial Residential ' Depanmen
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: Poch- Q.erce_ Eck
Property Tax ID #: 2-1 1P) t.1 Z 00 O pip io Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
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ST-tP_` ?%_01 30 !14, ZO ,�'C,✓v; 'c �[� r _t4t
�►� Ski � I DaTtt-�- �i y .. A-•��o L%a �.TS
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
V Electric _ Plumbing _ Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ (yb Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name
Name: wKarJ Sh, •�T/-+
Address: (q oC( 0,seeO�et or
Company: ►t C s
City: I -of P'WCe- State: ;ti
Address: vah%3n L^KC C.�'�
City: („,n C t. Stater
�—
Zip Code: 3519S2 Fax:
Phone No. 7 72 — '3,69c-�
Zip Code: :?&4 q <- t Fax:
E-Mail:
Phone No 56 1— H 5b• %'w)
Fill in fee simple Title Holder on next page ( if different
E-Mail c - &, —i7 i., Jer'✓1c e,, �
�7,.
State or County License F_1' l4 O tb cJ Li 3
from the Owner listed above)
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.
SUPPLEMENTAL CONSTRUCTION LIEN 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.
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contra or/License Holder
STATE OF FLORIDA
STATE OF FLORIDA --
COUNTY OF
COUNTY OF `-�i' "co?
Sworn to (or affirmed) and subscribed before me of
Swor o (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Ph sic I Pre s ce or Online Notarization
this day of 12020 by
this ay of 2021 by
Name of person making statement.
Name of person makings tement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
ced o'�
rn C-1
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State if Florida )
Commission No. (Seal)
Commissi°�e_`. KIM KEAHEY Se I)
� V
i _:^: Notary Public - State
iti'
&`i Commissior r �� 0374CC
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