HomeMy WebLinkAboutBUILDING PERMIT APPLICATION - 1
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /�� Z-��-� Permit Number:Qq\C-,-G3gG
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• JUL 14 2021
Building Permit Application
Planning and Development Services St.LucieCo
Building and Code Regulation Division Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:
0
Address: y V 9 l\ lH 7-i7 tLo
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PropertyTax ID#: i if! 7D6 -00) D Lot No.
Site Plan Name: 0 Gp pyl C-0/.Ch>M1 out" /� L✓�)� �� Block No.
Project Name:
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Additional work to,be performed under-this permit-check all that apply:
Mechanical —Gas Tank Gas Piping _Shutters —Windows/Doors-
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: y, Sq. Ft. of First Floor:
Cost of Construction: $ °� Utilities: _Sewer _Septic Building Height:
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Name �b a- .;1�1'I 2✓)�� ' Name: I �I 4 1 GY11 Z,,
Address cb I'jCI` N W l #W-A Al( �� Company,:
City:% .P)-ea i� StatefY-- Address: ��7i')� �� ���" d l.0
Zip Code 3"�� %a �l Fax: City 1 ) "�J�`)���U�? e- Stater
Phone No. ". Zip Code: 't-/
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Fill in fee simple Title Holder on next page( if different E-Mails
from the Owner listed above) State or. County License / �r/�3 5 i
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
NEW—
DESIGNER/ENGINEER: `Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Add Address:
City: State: City: State:
Zip: :r, ;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 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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON TIME JOB SITE BEFORE THE F187ST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDANIG YOUR NOTICE OF COMMENCEMENT."
"
Signature of Owner/Lesse Contractor as Agent for Owner Signature of Con(actor LicensAolder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF N, COUNTY OF��
The forgoing instrument was acknowledged before me The forgoing instrruj ent was acknowledged before me
this day of 20)-k by this day of J�\N 203.� by
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,S' t.- SCAN
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced V Produced 1. L
(Signature of Notary blic-State of Florida (Signature of No rX etc- I
o� ° DEANNA GIVENS
pE NA IVENS ` o Public-St
Commission No.� S a ~`
:a: ry P,)Ul date of Florida Commission No. fission k bblI�jj33orida
ovR,:^' My Comm,Expires g1120z5
a; CommisEx fires Ja0n828 52025
o-; Bonded thro
Bo ded through National
Notary Assn..
REVIEWS FR ND
PLANS VEGETATION SEA TURTLE. MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.