HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: XLI 7,ZC2.j
LLB " ...._
Permit Number:
Building Permit Application
Planning and Development- Services
Buildings and Code Regulation Division
2300 Virginia Avenue, Fort pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: A- JI C4LUMM2A17-
Property Tax ID #: 3 .fit , 7c?I -vv r -u
Lot No. iiJU
Site Plan Name: IgAtUEY FL,JC1- in1 s 1L
Block No,
Project Name: IAt`_S' l -tL /1 L L;,-1 f-L�
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
(Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
—Mechanical _ Gas Tank — Gas Piping
Electric — Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ '2 , ;49,6, uC)
OWNER/LESSEE:
_ Shutters Windows/Doors Pond
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: — Sewer _ Septic Building Height:
Name 171F1td�icl� f�JitrtLY
Address: 1, 2 7 S'i,,.t C y,t4 i/f/
City: t''oit- '�'z L V;j L state: FL
Zip Code: 2q t,�-N_3 Fax:
Phone No. -712. -Z6f? _ 2 y
E-Mail: iAdfra 0 A zn, %l L7tftL` Gv�r c
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: 16cj_
Company: A
Address: ZT-/ /kh/d
City: LL,-ram State: i-L-
Zip Code:-7-19,,° Fax: '72 z - 50u{s-c,Z72
Phone No 772 -J> U2-L
E-Mail itiipc e ,¢yr�/-c�[cC"P Lrorr
State or County License C LAC 15-27i''7I
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION-
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phan
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone;
�C_ Not Appli
State
— Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
— Not Applicable
State:
—Not Applicable
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 ali 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 o an attorn,ei before corrrmencin work or recordin our Notice of Commencement.
Signature of weer Less e/Co tractor as Agent for Owner
STATE O FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
this ? day of .T�i._ Physical Presence or Online Notarization
20L i by
h'AH Llt_tc L
Personally Known 4 OR Produced Identification
Type of Identification Produced
(Signature of Notary Pubfic- Sta
_F [L...:J_ s
Commission No. 66 i27LLg (Seal)
REVIEWS FRONT ZONING
COUNTER REVIEW
=RECEIVED
DATE
COMPLETED
''AY Ay`4 CRYSTAL, Y BISHOP
MY COMMISSION # GG127518
EXPtR July ES
• ,nF�,.� Y 24, 2021
SUPERVISOR PLANS VEGETATION SEA TURTLE
REVIEW REVIEW REVIEW REVIEW
MANGROVE
REVIEW