HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
��1c E U. RE_ RECEIVED
JUN ®7 2021
Building Permit Application PermittingDOPartmenr
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Planning and Development Services St. Count,.
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:
PROPQSED IMPR01%EMENT,LOCATIbN
Address: p
Property Tax ID#: J ��� / SRO U 4 �S" O U O ! Lot No. I D
Site Plan Name: k1//Lr' / � r N Block No-49�
Project Name: z�fz_'- �g_ "'t4
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DETAILED DESCRIPTION'OF WQRK
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New Electrical Meter Second Electrical Meter (Affidavit required)
CQNSTRUCTI4N fNFQRWION
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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: $ 1. 010 Utilities: —Sewer —Septic Building Height:
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QINNERjLESSEE CQNTRAGTOR
Name-rKe '"L-57C /`RA/ S K Name:
fl—
Address:2-7 5�: b Company:
City: �s Stater') Address: 'y�,
Zip Code: ? `/ q 93 Fax: ,,\\ City: ���— Stater
Phone No.7?� 6�6 -7 L�'LI U Zip Code:3 Fax:
E-Mail: Phone No / o�d
Fill in fee simple Title Holder on next page (if different E-Mail 0 d G - 22QAl G"ITI
from the Owner listed above) State or County Licensd' ?o-L3
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.
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DESIGNER/ENGINEER:" Not A hcable
_ _ PP MORTGAGE COMPANY: Not Applicable
Name:
Address: Address:
City:' States 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:Application9s-hereby made to,obtain a permit to do the work and installation as indicated.
1 certify that no work or installation has commencedpriorto the-issdance of a permit.
St.Lucie;Coun ,makes no representation that is granting a permit will authorize the.germit 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 mayapply.
Inconsideration of;the,granting of this requested permit,I doherebyagre'e that I will,in all respects,perform the work
in accordance with'th.e approved plans,the Florida Building Codes and St.Lucie-County Amendments.
The.following.buildingpermit>applications'are exernpt 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 reeordingyg,Ur:iQlice-ctf Commonrp►np- —
,r gRIVII z ucENs S; 14_r
Signature of Ovine/;LesseeJContraetor as_ ent for Owner `"
STATE OF FLORID
COUNTY OF � � y
sworn to("or affix j and subscribed before me of Physic r
this day o 20�2/by
J6 r r art .. - _
Name.&perso making statement:
Personally Known- ORNPNcedidergificatioD
Type of Identification Produced
(Signature of Nota Public-State"of Florida.)
Commission No. (Seal) AUDREY B.HUMPHREY
PAY COMMISSION#GG 300817
EXPIRES:March 6,2023
F�F F'.• Bonded Thru Notary Public Undervmters
REVIEWS FRONT ZONING - SUPERVISOR PLANS VEGETATION. SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
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COMPLETED
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