HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �'���1 Permit Number: a �,05�4Sd
RECEIVED
#�
_ MAY 1.12021
Building Permit Applications .
armiCiiag Department
Planning and Development Services St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
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Address: ra
Property Tax ID#:� �7d5 -�L>�G-l�Db -�°� Lot No.
Site Plan Name: � 64�tiA✓y�4 1r} (2 A,� h Block No.
Project Name:
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bA
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: Utilities: —Sewer —Septic Building Height:
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�Name �I Name:
ame: V i d y
C� VAddress: PE iL CSS'1\i^ 4-x=
>�-LFJ
-N*A
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City: a2�. l ':_L�e_�c ` State: ' Address: c4v l rL
Zip Code:�� fax: City: �-� it- - Stater
Phone No. Zip Code:;_��/�. Fax:
E-Mail: Phone No
Fill in fee simple Title Holder on next page( if different E-Mail C kA�s L Wlra-c
from the Owner listed above) State or County License b�1
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
I
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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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE. THE F!RST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORiui NIG YOUR NOTICE OF COMMENCEMENT."
Signature f Owner/ s o Agent for Owner Zignature Ho e
STATE OF FLORIDA STATE OF FLORID
COUNTY OF 6N, L, 6 c COUNTY OF S - Luct K
The forgoing instrument was acknowledged before me The figoing instrument was acknowledged before me
this�`� day of 2CPA by this day of V` gq 203� by
9, S e. V N 1M gc., �uS S Q \1 Yti plc�i
Name of person making staterfient, Name of person making state ent.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identific tion
Produced t. L. Produced �1.�L
(Signature of Notary P lic-State of Florida) (Signature of Not P.• ac; p,iie
ue DEANNA GIVENS
DEPPNDI
Gam` otary public
Commission No. '� ��. Nota{0� iorida Commission No. ,g H Florida
mmission n HH 086359
�� e` Commissi59 °f..... My Comm,Expires tan 28.2025
o� Comm.Ex 2025 Bonded t
Banded through ary Assr,
REVIEWS FRON OR PLANS VEGETATION SEA TURTLE A ROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.