HomeMy WebLinkAboutApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO B ACCEPTED
Date: Permit Number:
Building Permit Application
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:
Y ROPOSED IMPROVEMENT LOCATION:
Address:_ SZG I��y Sri «wl P rL.< P: 3�ic,4
II
Property Tax ID#:' %0 j- Oc 1- b U 0 1
Lot No.
1431-
Site Plan Name: +4ry m ° 4,tt b k --S /VA c
iS IIC - - / Block No. �=
Project Name: 2 O 3 M fM�� - - �
e r'M( e ( (ev IC
}i��iIPTION QF WORK.
,
1-0 A -Z�
New Electrical Meter Second Electrical Meter
CONSTRUCTION Y d £�RIVIATION; -
Additional work to be performed under this permit- check all thatapply:
_Mechanical _Gas Tank _Gas Piping _ shutters _Wind DgIcrs _ Pond
Electric _ Plumbing _ Sprinklers _ GE nerator _ Roof� Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of♦,�{Construction: $ Utilities: _Se wer _Septic Building Height:
Name Sei"V1{ IAJ (.tcyy.
Name:
IJUQ�
Addresss: S2o3 tMci+4u2 (�S I%[t
Company:
`GNt[(0r F-brr.P VtcL 1
City: f �. Qltrtt `, Stater
Address:
1 9t., SAilec uA-4v+J C?'n)
- L State:F 1
Zip Code: 731l Fax:
City:
Phone No. 1i2' 3Z 2-71 -3
Zip Cod!::
3 i/ Le Fax:
E-Mail: l,,)Ill l IJKS 6 w7, . Q SOeal.i &
Phonerlo
E-Mail
Fill in fee simple Title Holder on next page ( if different
i L3 -e'm ,
County License CzC JI
from the Owner listed above)
State or
If value of construction is 2500 or more, a RECORDED Notice of Commence
nent is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencemenj
is required.
'PPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
[c
or Applicable
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY
Name -
Add s:
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BO
Name: Nar
Address: Adc
City: City
Zip: Phone: Zip:
Not Applicable
COMPANY: _Not Applicable
OWNER/ CONTRACTOR AFFIDVff: 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 o a permit.
St. Lucie County makes no representation that is granting a permit will auth rize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bi ws 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 ani accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Comme cement 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 insp ction. If you intend to obtain financing, consult
with lender or an attornev before commenrino wnrk nr ray rriina vnnr l iro of r ,n nn.nrnmcnt
VN
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signatu
e o ,ontractor/License Holder
STATE OF FL9 n
STATE
OF FLORIDA' l IBC S
COUNTY OFT,,,,,,
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COUNTYOF
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Swgrn,to (or affirmed) and subscribed before me of
V, cal Pres or Online Notarization
this yof1 �@2B by
Swo
this 2
s ce or Online Notariza
dayoof1^Vr.-t.(7L1. 202� by
(or affirmed nd subscribed before me f y 1--ca
Name of person making statement.
Name o
person making statement. 3 Z.—
Personally Known OR Produced Identificatiof�
Type of Identific
Produced
ersona
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I K OR Produced Identific c@ ,1Oe`rs
lion J
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Produce
n d
5/2025
s
tary Pu lic- State of
n (Seal)
(Signature of Notary Pu lic State of Florid �� Notary Pu
Enu Kuhn
Commission No. y 1�C� (S my c«nrra
w . Etprea 03/
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FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
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COMPLETED
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