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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION ' r' - i All APPLICABLE INFO,(MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number:�C � Lo a" RECEIVED o JUL 14 .2021 Building Permit Ap plicatlOffrmitting Department St.Lucie County 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: ,PROPOSED IMPROVEMENT LOCATION: Address: Property Tax ID#: .�� 9 O S O O Z 1 7 Lot No. Site Plan Name: / Block No. Project Name: Afly DETAILED DESCRIPTION OF WORK: Z k S r i .Slew 4 d ff S' lO D L t o �a H f O as t y v e. P C ) Pa 'r P/1'Y) t'fl7 CAL 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 _Shutters _Windows/Doors _Pond Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: U Sq. Ft.of First Floor: Cost of Construction: $ 1�©Oa ©v Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name 111.,elod :cc, Name: 2� C/vt,e Address: 11SZO ho&ImaSo. C Company:3ZC- C.o^uety_ lulus LLC City: /Q, rY 1oA e State: FL Address/ 92-g 0 Zip Code: Fax:Fax: City: 64 Glut_ State: Phone No. ?72 -e//0' /yj 2 Zip Code: '3`f i �1 Fax: E-Mail: Phone No-?72 Z 1 G- L 2 I (o Fill in fee simple Title Holder on next page(if different E-Mail 1JIC _ -c -� v S P C.et� from the Owner listed above) State or County License 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. SUPPLEMENTA L`CONSTRUCTION LIEN LAW INF,ORIVIATIaN - DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: 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 instal lation-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 le er 9nan attorney before commencing work or recording our Notice of Commencement.4V_1� Signat a of Owner/Lessee/Contractor as Agent for Owner ST E OF FLORIDA COUNTY OF Sworn t (or of it )and subscribed before me of Physical Presence or Online Notarization this day of 2Q2L by ,sGKc C�r-01L , � Name of person maki�tatement. Personally Known OR Produced Identification Type of Identification Produced (2�� (0i (Signature of NotaW Public-State of Florida) Commission No. (Seal) ;=oiYP4c AUDREYB.HUMPHREY *_ MY COMMISSION#GG 300817 EXPIRES:March 6,2023 'rFOF,F°P Bonded Thru Notary Public Underwriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev /20/21