HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater a3 a1 Permit Number: �`Orc'4ro�t'1
11., UGME `h1 RECEIVED
r- pl i j W JUN 2 3 2021
Building Permit Application St.Lucie Couvtv
Planning and Development Services Ferrnittin
Building'and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-157T
PERMIT APPLICATION FOR: 1
-
PRQPC4SED IMPROVEMENT LOCATiQN
Address: ) (0 4 f��
PropertyTax ID#: A Lot No.
4 Site Plan Name: - .l� 6U4 v Block No.
Project Name:
DETAILED DESCRIPTION
OF WORK.;
Lae a
(,� c
OVL V444U 1i)iwu4u) &AA, &-/j
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New Electrical Meter Second Electrical Meter (Affidavit required)
CQNSTRUCTIQN INFORIVIATIC'N
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: 1 ' Sq. Ft. of First Floor:
Cost of Construction: $ . '��, 000, GU Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE CQNTRA'OR
, e
Name P - 1i Name:
Addres ltc30 . 40 -1 Company: uz C;
City: State: . Addres : �G'(� .z
Zip Code: C� Fax: City: Stater
Phone No. 3 D.3C08 1 - q 3 77 Zip Code:, ,/�/%/�/?o 0 Fax:.
E-Mail: �` e-A fl A d % a ,dc1/19 Phone No 7 �-�) 404,
97 Sr0
Fill in fee simple Title Holder on next page (if different E-Mail Ale � H04,e01V
from the Owner listed above) State or County License I?R OD la 7 V 7
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.
SU PFLEMENT/ L CONSTRUCTIQN LIEN LAIN INFQRMATIOII.
:
DESIGNER/ENGINEER: V Not Applicable MORTGA OMPANY: _Not Applicable
Name: Name: L O
Address: Address: )
City: State: City: ,np Stater l .
Zip: Phone Zip: SO (a Phone: KPQ
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 financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
Signature of Owner/Less /Contractor a ant for Owner
STATE OF FLORIDA
COUNTY OF I�e��.,�
Sworn to(or affirmed)and subscribed before me of V Physical Presence or Online Notarization
this ZI) day of 20_77�J, by
Name of person making statem nt.
Personally Known OR Produced Identification
Typ Identif' ation Produced
t�
(Sig re f Notary Public-Stig f Florida) q' LAURIE C SNYDER
Sr
G� I �O U (Sea] = MY COMMISSION#GG139080
Commission No. `.=
',+roFd EXPIRES August 28,2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev 5/20/21