HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Date:
■
Building Permit Application RECEIVED
Planning and Development Services MAY 13 2021
Building and Code Regulation Division
Department
2300 Virginia Avenue, Fort Pierce FL 34982 Pormi,ting
ResidentialSt. Lucie county
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT TYPE:
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Address: % ao i's
PropertyTaxlD#: J SO l 00'Q0 4060-6 Lot No.
Site Plan Name: 6 r Block No.
Project Name: r) 0 'S res
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Additional work to be performed under this permit- check all that apply:
—Mechanical Gas Tank —Gas Piping _Shutters —Windows/Doors
/ Electric Plumbing Sprinklers — Generator Roof —Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: '4
')15 01
Cost of Construction: $ 3Z, 020 Utilities: —Sewer _Septic Building Height:
775:
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Name:
Address. ebryl'p
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6f State Address
CityA
C, State:
A Fax: , 111,4u".;.
Phone No. • 7-7 M 71 Fax:
E-Mail:ripim IAJ 10 f 0 Phone No
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Fill in fee simple Title Holder on next page( if di rr -Mail ;N
from the Owner listed above) State or County License _Q_(n Ck 10560
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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 structure. Pleae conflict consult withpyoiurHlome Owners Association Owners tion andrreviewbylaws
your deed or any restrictions nts that which may arestrict or . prohibit such
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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE F!R5T INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH HOUR LENDER OR AN ATTORNEY BEFORE RECORD1.'G YOUR NOTICE OF COMMENCEMENT:"
Si ature of Owner/ Lessee/Contractor'as Agent for Owner Signature f Contractor/Lieense•Holder
STATE OF FLORID / STATE OF FLORIDA cc
COUNTY OF • �1%Lr'� COUNTY OF Jr• �A�'( �--
The for oing instru nt was acknowledge, before me
this day of 20� by
Name of person making st tement.
Personally Known OR Produced Identification
Tvpe of Identification
( ygh�ture of Notary Public_
Cry ir3issinn No.
14
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FRONT'
COUNTER,
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The forgoing instrument was acknowledged before me
this 1,7>_ day of 20A71 by
Name of person aking statement.
Personally Known `x OR Produced Identification
Type of Identification
Produced
//# 1/ . -�
Signature of Notary Pu c,� t,�,;oj�Florj(�gRIE CONIGLIO
° Notary Public • State of Florida
�? # HH 26083
ComiLs�lj
s' ANNMARIE CONIGLIO
�.
t�g�a�Pubiic State of Florida
ommission No.
�, My Comm. Expires Nov 21, 2024
yo
Commissfani# HH 26083
My Comm. Expires Nov 21, 202
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Bonded through National Notary Assn.
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