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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 0 3, ._ RECEIVED MAY 2.8 2021 Building Permit Application Aa mltti Department Planning and Development Services t. Cie County 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: PROPOSED IM p ' OUEMENT LOCATION: Address: Property Tax ID#: :3_ q ' C/ p n o Lot No. Site Plan Name: Block No. Project Name: DETAILED ©f�SCRIP �/'ON Q WQRK: New Electrical Meter_ (fi�Second Electrical Meter . ^) CO STRUCTION INFORMATION; 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 itch Total Sq. Ft of Construction: 2.2 C0 Sq. Ft. of First Floor: Cost of Construction: $ �C�.,CD Utilities: _Sewer _Septic Building Height: OWNERf LE�S�SEE; CONTRACTOR: Name I A Name: Address: eA R.0 Company: City: G��' 7F`�-�('' State: Address: Zip Code: . L q5'_G Fax: City: State: Phone No. �� 3� Zip Code: Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License 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. € � ti� 0 IS "` 5q 1, " `�+3� li "t-r ..�.. .. 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 i with lend attornev be mencing work or recording our Notice of Commencement. F.: Sig ature of w er/Le ee/Contrac or a gent for Owner STATE OF FLORIDA ' COUNTY OF Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization this day-of 20i2 by CAM ) J* R-Yn ,\N n J �h Name of person making statement. Personally Known OR Prod uc d Identification Type of Identification Produced . ��... LUI 01/t- tv (Signature of Notary Publ State of Florida AUDREY B.HUMPHREY Commission No. Seal =-°' c (Seal) � MY COMMISSION#GG 3fi0617 *' EXPIRES:March 6,2023 BondedThruN01MPu6licUnderwriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev 5/20/21