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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �t Date: C°,�51�� RECEIVED Permit Number: "%),V0 *' Ti JUN 2 5 2021 u:s lr o o St.Lug gunty B ing Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)46271553 Fax: (772)462-1578 PERMIT APPLICATION FOR: •',� z���f `� ��-�I' [ ' �.#T t,s9'Lx'S's'r°`� �Y`�,E �� �A,� ���,�`'����s.�� ,��.� sv��e r'�x�i�£�''`" ������LFL'-. i.�������t 'r''gPy� � � �„ �,�. d�'{; a✓ `� �. �+;.a 3�- -*, � a..�G �"„�+,� .,.1N� z, Property Tax ID#: L�t� Z C 10 Q 1 92 — 5 ©C") — 3 Lot No. Site Plan Name: Block No. Project Name: 1' .a.11a�:,�._,M . Si D Ceo f(a� Z��v c�- tom,¢ '«' H t,� t New Electrical Meter Second Electrical Meter (Affidavit required) 3 ' k b �i � 'E -, 4 c}a � - Lb:r.b �t '..� .ia T x -: �, -.�,..«=z'z# � y,'�--"•-erx; �. i... ..c,M .U.,•r,,w .,ems__:-m., .�:,_L. �, sa�T+x,F�._ u_:, a� .w�:..x., r.�1>, §..._,x',e�T.�, ,�v..�.. .eA�`F .., �1.0>.,;,,,a �h>... ,.�;� . ..,,_`�>.,z �r.- �Ai._�m ��2`i.�v Additional work to be performed under this permit-check all that apply: _Mechanical 6umbing Gas Tank _Gas Piping Shutters Windows/Doors Pond —Electric —Sprinklers —Generator —Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ .r�;.�C Utilities: _Sewer _Septic Building Height: .g © ���L���4L"�i sF: + �'.-, � .�4 r'��•e w-�k�. , 3 s y._ � t^'"'c l� ,'�`'*...." ��-�- W .. J� �'t"r .. ;?; �z-' .,d 'Name: Company: y: ... r f /cam r City: `h(11(A'4 c A— State:S I` Address: `I 2 Zip Code: 33 6 Fax: City: C State: Phone No -? 7 L 37�D Zip Cod 3�GI�IC� Fax: E-Mail: Phone No - 7 Z- S 0 l/S y Fill in fee simple Title Holder on next page (if different E-Mail 144 Y-ro p fc:,W • o%C-111-7 from the Owner listed above) State or County License Q:� 1� S� 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. DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable 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 impr v ents to your property. A Notice of Commencement must be recorded in the public records of St. Luc' unity and posted on the jobsite before the first inspection. If you intend to obtain financing, consult wi I d r or an attorney before commencing work or recording our Notice of Commencement. S a7ture f Owner/Lessee/Contractor as Agent for Owner i STATE OF FLORIDA COUNTY OF sA_ N_ Sworn to (or affirmed)and subscribed before me of Physical Presence or Online Notarization thisa.:'D day of 20-'1) by Q ��Q.r� Y�6'yidC\ Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced R \, 4b L (Signature of Notary ublic-State o F r" DEANNA GIVENS 0c Commission No. ° ` 4n: N @� •State of Florida < Com�ssion n HH 086352025 My Comm.Expires Jan ot a a Assn. .,,OF F�;.• Bonded through National N ry REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5/20/21