HomeMy WebLinkAboutBuilding Permit Application :7,77
r All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: r c�L-a,\ Permit Number: Q'%(:+_(�0�7 ts
RECENED
s JUN 0 8 2021
Building Permit Application sr--WQ10 any
Planning and Development Services %r
Building and Code Regulation Division Commercial Residential l
2300.,Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)'462-1578
PERMIT APPLICATION FOR: ��Q _ AA-ITD
PROPOSED IM�PROUEMENT LOCATION:
Address: ZS-L-25 I.,r�t !�/- 13F ��rn �Lr �Y*i�l
Property Tax ID#: ?,q(_ R'01 6201�2 &�, -2 Lot No. ti
Site Plan Name: 9�ScilewLc Block No.
Project Name:
DETAILED DESCRIPTION P WORK;
l O �1Mou� C,fcS i t t3G, S A 4-m E-.3 (?-2 c-c_Ren�EI i.l A-u D W S c A-LL- 0"l,cJ
`Pe I. ,D yr.> S i C-1 - U-u D&WA ,.aS J%A L - S Ac�s'C7 PEW S't-f006,l�-5 A-',)►D New Electrical Meter Second Electrical Meter
CONSTRU TION INFORMA [ON;
Additional work to be performed under this permit-check all that apply:
I
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond
Electric _Plumbing _Sprinklers _Generator Roof 571 V(-L Pitch
Total Sq. Ft of Construction: 37bo• Sq. Ft. of First Floor:
Cost of Construction: $ 1 5_(o5_6 o Utilities: —Sewer —Septic Building Height: S-r
OWNER/LE-�S�&S CONTRACTOR:
Name "DDAje Suw cTtt Name: C.-_C , :E�AcA&=e
Address: 25-c3 caeA�twc r;4 Lt-4 Company:('A-s7-��c�fLv t2cx was LLC_
City: s-i PLee,&G State:a. Address: 32.11 b[_c.4�-cC�'r� Aua
Zip Code: 34ct fS( Fax: City: r ecCV_c� Stater(
Phone No. vt-iZ_ ,33Z 'gSrg0 Zip Code: 3�-4 '8? Fax:
E-Mail: Phone No M,?- 2lro-eoLF-7
Fill in fee simple Title Holder on next page( if different E-Mail CA=S%z*j 6cn11a, (z�ofii�� 6�►�cacL. � -�
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.
N C*dUR{ t1�C N R I,NNNNNNSA!A CNf ?F M t
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 t- property. A Notice of Commencement must be recorded in theEncement.
blic records of St.
Lucie Co ty d pos ed on the jobsite before the first inspection. If in o tafinancing, consult
with I e or an ne � efore commencin work or recordin our ice of Com
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 6k- UOe� COUNTY OF !&3r,Ut-,'Zk
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this_'�"S day of 211b.1 by this °'t, day of Z%S Ak ,2Z�_\ by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification L
Produced
Produced
(Signature of Notary Public-State of Florida) (Signature of N t li -
C"t�1 c�,�Os GIVENS 7 :'t� ave,• .�,�DEAN -state of
Commission No: el),NNA f Florida Commission lic State of FI al
y of ••, state o ,;��. II@@ )
1��: Notary Public HH 086159 ` c`: �Om on q HH 08635
Commission n 2B,2025 f{ `y� '' My Comm. xpires Jan 28,2025
�`:y o off•' MY Comm National Notary ss . e.
REVIEWS FRONT Oil h{0u5 R PLANS G TATION SEA TURTLE MANGROVE
COUNTERL REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.5/15/20