HomeMy WebLinkAboutBuilding Permit Application ii
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: J' )-O► 1 Permit Number:
RECEIVED
2 o I L U C D I E = �' MAY 13 2021
PwrnittLng Department
Building Permit Application St. Lucie county
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:
PRQPOSED,IMPROVEMENT LOCATION:
Address: \ I - s l 1
Property Tax ID#: � )I Q] " 1- Lot No. 1'i
Site Plan Name: Block No.
Project Name:
DETAILED'DESCRIPTI IN OF WORK,
O
C&I:e 0&5e - h :hz - taA(- iv bin
New Electrical Meter Second Electrical Meter ph.&_
CONSTRUCTION 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 Pitch ;
.Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ ��'�'O� Utilities: —Sewer —Septic Building Height:
OWN ER%LESSEE: CONTRACTOR:
Name Name:
Address: Company:
City: F-ccA- 'Pl -s-sz ' State: Address:
Zip Code:,?:)�-�1 Fax: City: State:
Phone No.-na:`pDp-r5]5 \ Zip Code: Fax:
E-Mail: ptoc i \ CyAC.1(-\*\ n DCA 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.
F�
i
S,UPPLEMENTAL`CONSTRUCTION LIEN LAW INFORMATION:
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 fina;ncing,`cons'ult
with lender or an attorney before commencing work or recording our Notice of Commencement.'
Signa ure of Owner/Lessee/Contractor as Agent for Owner Signat re of Contractor/License Holder
STATE OF FLO,S�tIDA STATE OF FLO
t��
COUNTY OFUPlumCOUNTY OF
rn to(or affirmed)and subscribed before me of Lrntoffirmed)and subscribed before me of
Physical Presence r Online Notarization Prese ce or Online Notarization
this�day of 20201by of n f A 202 by
Name f person making statement. am of person making statement.
Personally Known OR Produced Identification Pers nally Known OR Produced Identification
Type of Id if tion n ,,' n ,, Typ f leifttm
P ocl c kt � u . Pr c
(Sig ature of otar Pu i Florid ( gn lure of Not t e o
Notary�u Iic•State of Florida of blu tat of Florida
Commission N HH 066268
Commission No. mission X c i# 2
" •••�••••'••• AIyCo��piresNov22,2024 Commission N ."•.. • � m,Expir��d4]t.2024
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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