HomeMy WebLinkAboutBuilding Permit ApplicationAll APPl1[ AR!F WF" MIXT RF EY MIDIF'FM FR APP/ L#-A71PW T" iRF ADD
Date:
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Permit Number: `Cb
Building Permit Application
Planning and Development Services
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:
Address: , o 1\0 con 0 e- W. k ;�K7)!( . V\ ,4N (NLh say-, -r-,\ � i 1 3 � °��► G
Property Tax 1D #: S n no ^ O �k3 3 `�t 33 I2 Lot No.
Site Plan Name:
Project Name:
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit -check all that apply:
Mechanical
Electric
Gas Tank
—Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ . S c 0
_ Gas Piping
Sprinklers
Block No.
_ Shutters _ Windows/Doors _ Pond
_Generator _hoof Pitch
Sq. Ft of First Floor:
Uffliiies: _Sewer _Septic Building Height:
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Name:1�..►�\2
Address: o Flo G��„oeQ.►,;,,n,5 Q(
Company:_ 11\\c-CCL, 0U\ '(a:t Co�n�;�riov�vra Sc l ty�
Cit;/:y►J\chi,; n ow \S�o�.\ Stater
J#ddress:_24 *\"kso.n.. Sk
Gty: State:
Zip Code. 3 y q T_ Fax:
Phone No. b - 1 k S 6
Zip Code: J-\ -1 Fax:
E-Mail: \oc\%5 @. w \ • coati~,,
Phone No '112 - -\,d �- o % kR 2
E-Mail v\err o..c.� e� ac- iQ
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County license Lam, e- J,!% \ 12 3 9�
If va line of construction is 25W 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.
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DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zap: 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 permitvAI 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 month your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permk 1 do hereby agree mat I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St Lude 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 Contrrtencernent 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 your Notice of CcKnmencement.
Agent for Owner
STATE OF FLORIDA v
COUNTY OF 11'iN-4) /t
Sw rn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this 1 J61 day of -�Vne .2026 by I<`/k-
_ y i -,Vf
Name of person making statement
Personally Known OR Produced Identification X
Type of Identification
Produced r4-1)L -14t051u832o50
(Signature of Notary Publ"
iY oC'•, J ES R. MCAFEE
ia4 :`t'��q Notary Public - State of Florida
Commission No.fi� 0-230
t' �0:
60*ion # HH 072383
My Comm. Expires Dec 15, 2024
Bonded through National Notary Assn.
STATE OF FLORIDA
COUNTY OF .14 r,
Sworn to (or affirmed) and subscribed before me of
K _ Physical Presence or Online Notarization
this 1 V day of 7 u n-e. 20201 by I; vie = I;PF
Name of person making statemenL
Personally Known OR Produced Identification
Type of Identification
Produced r-L OL ;tYlo 5'16) 83 2660
(Signature of Notary Public- aotary Public - State of Flor
`=
e. Commission # HH 072383
COmm155100No.f%a723a3•', }g� qq¢¢��m.Expires Dec 15,21
r on�$� t I gh National Notary A
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Kev. 5/b/1U