HomeMy WebLinkAboutpermit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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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: 5 j C 'aY"1 DicciD t�)Yz_— 34(:714Lo
Property Tax ID #: Lot No. Z3lkq
Site Plan Name: hQl(f Cja.I CSfo+c-s Block No. I�
Project Name:
>QLA�� -VF ZD- CQ 0 l .
New Electrical Meter Second Electrical Meter
(Affidavit required)
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Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters 4 Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $
Name ILiT'n C
Address:_6,509-� I;nn �1 rGc>
City: E - Pierc< - State:
Zip Code: 34Q4(_n Fax:
Phone No. _n? - -45 • C p1b
E-Mail:
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: CzY) nie. Cyr—GQCe
Company: D C-1CaCCQe1_ c1CCDr,S
Address: 435 t jL*. ) E rrt-cr I2ri s C' Dr -
City: PDr-f- St- U LC i e- Stater
Zip Code: Fax:-n-1-4tco--1&635
Phone No -1-1-4 • L",oQ --l(03 0
E-Mai
State or County
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.
31
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DESIGNER/ENGINEER:
Name:_
Address:
City: _
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable MORTGAGE COMPANY: Not Applicable
Name:
State:
Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
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 vour Notice of Commencement.
J
Signature of Owner/ Les—sTelContrNctor as Agent for Owner
STATE OF FLORIDA
COUNTY OF %1Q+ Lvc_i C-1
Sworn to (or affirmed) and subscribed before me of /Physical Presence or Online Notarization
this 20 day of 07D 20_U by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced
(Signatufe of Notary Public- St�ee of Florida )
Commission No. I7�T ��/ r (Seal)
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
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MICM4ELWALZAK
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COmmisa O M Fih 47991
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Ey►fts Febru4fy 2, 2025
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SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW