HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -'lT�a.1, Permit Number:
RECEIVED
°1 U K.
Ul 9 2Q21
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Building Permit Application st L
Planning and Development Services it
Building Regulation Division Commercial Residential
d 9 and Code
Phone:l Z)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
PRQPOSED IIVIPROUEME:NT LOCAT.LON_
Address: �I.P_5<,o9tiP)eI* C12CL e
Property Tax ID#: 5410 ',5-9 3 —eglas " 0670"s Lot No. l O
Site Plan.Name: !�� °�� 04 LGl��IT/¢,020 _ Block No.
ProiectNamP_ 4 P LUG U tOLSM S Re PzA g.eme i,Tt
DETAILED DESCRIPTION OF 1NORK
_ _fix a.
720 e 69 c �� �N�e '5 r- 2r69 UlAIM LT
M01 - slog- IMPACT W1NDaW5 WITM RC/14R0 >°d s6¢v���S
New Electrical Meter Second Electrical Meter (Affidavit required)
CQNSTRUCTION INFORiUTATION i .r mfi
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters X Windows Doors _Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Constructi,pn: Sq. Ft. of First Floor:
Cost of Construction: $ ,2®®® ®® Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE CONTRACTOR:_
v,
Ainmo
,Address: S-9® 7,4C��I�aJDiQlj4 ctget(� Company:
City: > AR=Pfe'e-ee- F'L State:/�L Address:
Zip Code: 94L?J92 Fax: City: State:
Phone No. 772 —4"c 4� o*/ Zip Code: Fax:
E-Mail: �jp6A-�- �1�`�1V1Q-BC_rC�� Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is.required.
I it vaiue of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required. I
t
SUPLEIVIENTAL CONSTRUCTION LN.LAW INFORMATION .'
u . _. . ' I'u.
/ — pp MORTGAGE COMPANY: Not Applicable
DESIGNER ENGINEER: Not Applicable e
_-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.
PP Y
!certifyahat.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 buildine.nermit anolications are exempt from undergoine_a full concurrencv 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 our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization
th!0,6 day of 20b,,N by
Name of person making statement.
Personally Known OR Protcued Identification
Type of Identification Produced �.L
III
(Signature of Notary P lic- DEANNAGME-45
kfFiorieallotary Public•State cCommission No. �6 (Sefadmission `4H086835Zp25
e, fires sac )
i?F My Comm.Exp
...�r;
�•Bonded through Naticnai Notary Assn.
REVIEVIUS- FRONT ZONING. SUPERVISOR] PLANS ._. VEGETATION SEA-TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5/20/21
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