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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLE i ro FOR APPLICATION TO BE ACCEPTED Date: RECEIVED Permit Number: ra 9Uo JUL 212021 0 9 .; St Lucie county 9 L c � ° IDr" Bugg 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: PROPOSED IMPROVEMENT LOCATION: Address: It c t F Property Tax ID #: 33L/- $Da- ®0 © 1 'crw -O Lot No. Site Plan Name: 77 Block No. Project Name: dt/l�0 �/O�S6r �5�✓�/��'l>91��'� I DETAILED DESCRIPTION OF WORK: L4� New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additional work to be performed under this permit- check all that apply: M chanical Electric Gas Tank _ Plumbing Total Sq. Ft of Construction: Cost of Construction: $ Gas Piping _ Sprinklers (Affidavit required) Shutters _ Windows/Doors _ Pond _ Generator _ Roof Pitch Sq. Ft. of First Floor: Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name : &p0 "'`z-/-/ 5M// Name: d Address: Z&96 1�vt/-e✓�l/,-q A 2 Company: Loa City: P f!:!� !W � z"-C State: F/ Zip Code: ��Y6 Fax: Phone No. 17-,� eL- q %c1- `3 "�3 60" - Address: City: OP'f Stater( Zip Code: 7gcc 73 Fax: ---' Phone No % %•�' ��g' - 3�9 �f E-Mail: TTGA L/ rj7d // KV Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail O�'Q �'/2G.0 <a j� Q �m,q,L, C 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. 101 SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: 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 attornevJaefore commencing work or recordine vour Notice of Commencement. Signature of Owner/ Lessee/Eontractbr as Agent for Owner STATE OF FLORIDA COUNTY OF Sworn to (or affirmed) and subs ribed before me of Physical Presence or Online Notarization this 2.-1 day of :S 2021 by [ bnrl fin �&t , Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced F 1_, 0 L (Signature of Commission No. REVIEWS I FRONT COUNTER DATE RECEIVED DATE COMPLETED ELLEN VAUGH publi State of FIqq ida-Notary —CommissG �a )GG 2.70079 MY Commission Exp October 22 z0 s ROEVI NING W I SUPERVISREVIEWOR I REV EW I VEGETATIEV EWON I SEATURTREV EWLE MREV EWVE