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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO/MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U-1 Date: 1r� ! to7.1 Permit Number: RECEIVED O MAY 17 2021 �i :.o Building Permit Application pflrmlWngDepartment Planning and Development Services st. Lucie 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 [M ,EME'NT LOCATION .. . -4 -k _D Address: 34 l7 NW (rj %I A I Property Tax ID #: q Z. 0— 0037. Poo- Z. Lot No. Site Plan Name: 1t ?144 Z Block No. Project Name: NO.bO.�� �� Lak si&, A-C.R✓,4Y CQ k, f ate- DETAILED DESCRIPTION OF WORK: - - _ __ ._ .._..: __.. . _.... -.._ .� ._ ._- -__.._ ..0-� �%G!'►'10 � iY�I`17h ek I�S�f'I ng S New Electrical Meter Second Electrical Meter CONSTRUC.TI!ON INfORMATLON: 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 _lR�oloff Pitch Total Sq. Ft of Construction: ) /a 0 © Sq. Ft. of First Floor: �/ Py Cost of Construction: $ J 10oo Utilities: —Sewer _Septic Building Height: MSnc 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. OWNER/LESS;EE;. CON'1"RACTO.R . . Name �'o ✓ �S Name:�(��g(,� O'Neill( Addres : O �'�' ' I Company: � r.�.� SU,PPLEM,ENTAL�CONSTRUCTION LIEN LAW' I'NFOR,MATIQ:N ' DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: Safe eSi` P _ Name: Address: ? r ti ik cir _iPOP Address: City: Ju i it tState: rt City: State: zip: 33 S Phone �0 Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Applicable _ Name: Sgrwif kf owyler o,4 D✓evi0tt5gme _Not 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 with lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Own r/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 3 - U.)c..2 . COUNTY OF dj' �'d Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization "hysical Prese ce or Online Notarization this 1611 day of t1v\" , 2020 by this 15Nay of 2_.OW by ino 1 "l �1'ICr'Z�eI / i Name of person making statement. Name of person making statement. Personally Known W OR Produced Identification Personally Known )(0, OR Produced Identification Type of Identification Type of Identification Produced M;, Pr duced A"i FI (Signature of N ary Public- State of y j"thy (Signature of Notary Pu I c- State of t �' Notary Public •State of Notary Public Commission No.-GV�69010� State ofFlorlda, o" commission # HH 03 Commission No. 4T (p a yComm.ExpiresJan b 1, Comm# HH0901 and d through National Not ry Eipirds 20 202 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION - SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.