HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST
MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED o ( C'e
Date: 6 _D � ')A Permit Number: � �-
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Building Permit Applicat n o� w e'o
Planning and Development Services q�iW1&gG��
Building and Code Regulation Division Commercial RCSiclential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
OPOSED,I'MPROVEM=ENT LOCATION:,,,, . � .�.. „ , .. - ••
Address: SO 7 4)eor w5
Property Tax ID#: 61'66 2_ 49 r0 S D rj0 I Lot No. /Q
Site Plan Name: Block No. /S_
Project Name:
DETAILED DEkRIPTION rOF WORKS
P
4 `sa� Q�fio 2b
New Electrical Meter Second Electrical Meter
CONSTRUCTION'I'N FORMATI ON:. .
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: a't 7&0 Sq. Ft. of First Floor:
Cost of Construction:$ r/ �S 1 Q Utilities: _Sewer _Septic Building Height:
-OWNER�LESSEE s,x 'C'ONTRACTOR:
N'a T.e:. -JV am e LD
Address: O`7.'1�ze_a i F?—S r Company,.'„
'City.-' Ce State Add"re'ss: �. r � .'�G/I I sP
Zip Code:,5``21,5__�/ Fax: �''', Ci ( ? State:
Phone No. 7 7,;, -370-3?R 7 Zip Code: ?j�YS' Fax: z11rrT e4G-7
E-Mail: ,,rr) �ii�i�r►G�l�® /Yl�r� Phone No
Fill in fee simple Title Holder on next page(if different E-Mail_(i-H le y 6!r 37 27p , COS^^
from the Owner listed above). State or County License C 1055997
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.
S60LEMEN6L CCtNSTRU.CTION LIEN LAW INFORMATION
r.
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: Stater
Zip: Phone, Zip: Phone:
FEE SIMPLE TITLEHOLDER:-- 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 your Notice of Commencement.
9�1� "I _4�� V,<,
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �, l,Uc,(� COUNTY OF 'I'. Luc.t-e
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed) and subscribed before me of
physical Presence or Online Notarization Ph sical Presence or Online Notarization
this day of Q� 202f by this day of 2021 by
Name of person making statement. Name of person making statement.
Personally Known /I OR Produced Identification Personally Known 61-1 OR Produced Identification
Type of Identification Type of Identification
Produced Produced
�JtiewC , rr
(Signature of Notary Public-State of F r' re of otary Public-Stat ) tyrl G Dray.d
y�r ry Notary Public State of Florida Q mommjs9ic;n GCi 2S2 0
Commission No. a � at' e%I) Karyn G Drawdy mi ion No. " • Se ��11���z�
My commiseion GG 6 �
J Fd; Expires o2/1112023
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.