HomeMy WebLinkAboutBuilding Permit ApplicationAII,APPLICABLEiNFO_MU$T.j.BE..COMP,LETED :FOR AP. PI.ICATION TO BE ACCEPTED
Date:® PermNurnber.'
V
p9 Co
Building Perw pplication
Planning• and: Development Services
Building and Code Regulation Division Commercial Residential /X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772Y 462-1578
PERMIT APPLICATION FOR:
Address: Zydb�G U)'Pr�
Property Tax 1 D #: 3 Z- Lot No. Z
Site Plan Name: lz\xsS I-3 ( Block No.
Project Name:
-2,15 3- _Z4)T0
l— Cz S 140V Vt c
New electrical Meter_ Second Electrical Meter
Additional work to be performed under this permit- check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters )6 Windows/Doors _ Pond
�O Electric 1C Plumbing _ Sprinklers _ Generator SG Roof Pitch
l/nttg
J
Total Sq. Ft of Construction: , 7 Z3 Sq. Ft. of First Floor:
Cost of Construction: $ QGO Utilities: _Sewer _Septic Building Height: %L
���SSip,)
607
Name `��nl G(-�y2isT FS
Name: 1�ry
Company: ;Z01') '- sTiLdo-r o")
Address: S413 !' usJ5 G377 V 01
City: �Oi2 i -?, cam& State- J�L
Address: Z30 vet I cM^Ock �-
Zip Code: 3q9 (8Z. Fax:
City: rozl T16-i?_Cz Stater
Phone No. 7i 7-7 0
Zip Code: 3418V . Fax: 71Z-40-03
E-Mail:
Phone No -
Fill in fee simple Title Holder on next page (if different
E-Mail Z`1
State or County License CMG 13 Z7Z 93
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.
Name: KPto
Address: 138
City: -6% fie r6, State: J5:'-/—
Zip: Phone=.-871 -Zy5)
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
MORTGAGE COMPANY: _,Not Applicable
Name:
Address: '?-446 PAM� -be, off;
City: C 44iLkSs_7brj Stater SC:
Zip: Z-1464 . Phone: 77Z-`yd9 ZSI Z
Not Applicable BONDING COMPANY:
Name:
Address:.
Zip: Phone:
Applicable
UWNtit/ I�QNTRQCTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
1`eertifyahat rto wgrk or installation has commenced prior to the issuance of a ::permit;
St. Lucie County makes no representation that is granting a permit will authoriie the permit holderto build the subject structure
which is in.conflict with any,app.licable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owriers Association and review your deed for any restrictions which may apply.
In consideration`ofthe 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,
accessorystructures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING% TO 01A�NER Your`failure to Record4 Notice of Commencement may result in paying twice for
improvements to your Property A`N.otice'of Commencement must' be recorded inthe public: records of St.,
Lucie County and posted -n the jobsite before the first inspection' if , you Intend.to obtain,financing, consult
with lender or an attorney before commencing work or or i our Ntitice of Commencement.
ig ature,o Ownec/ Lessee/Contractor as Agent for Owner
4 ,. ,,ten ,�.
Signatu of Co tra r/License Holder .
STATE OF FLO IL�4 �.
STATE OF FLOR
COUNTY OF����
COUNTY.OF--- �
orn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
thi day of 20� by
this day of 20 4 by
ZN
Name o p rson make g statement.
Name of person making statement.
Personally Knoo� OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
BARBRA AG00DMA
ignature of Notary ublic- Statewo ) CominbWW#GG 1981
BRA (Signature of Notary - State g a) BARA®OODMAN
y E*iw Mardi 20,2022
Commission N avN ea"commission
FCORIRIIb110i1 JI®01"I'm
No.Q-� 9,�-
SeMVMMaci20,2022
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS'
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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