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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:—\\ \s Permit Number: RECEIVED Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial JUL 19 2021 St. Lualo rour'ty PZtting Residential %` PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATIOIi- Address: /06 126W l /�&— �2 Property Tax ID #: 24 93 _eel -- XCS�Ooo � d Lot No. Site Plan Name: _ � Block No. —! Project Name: i A/ DETAILED DESCRIPTION OF WORK: metI(�c MIS TW - /�)A l 61 C 0 &POGIE C;hc71ES ZAM / & 1,*d& 1 f /44W e)fV Mpwr New Electrical Meter Second Electrical Meter (Affidavit required) ;5�F ' W/ff 16 CONSTRUCTION INFORMATION: Additional work to be performed under this permit— check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond Electric _ PlumbiZ/A _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: . Sq. Ft. of First Floor: Cost of Construction: $ / Utilities: —Sewer —Septic Building Height: OWNER LESSEE: CONTRACTOR: Name Name: Company: Address: 066 ZRNCJ City: wx , State: _T_ Address: Zip Code: Fax: City: State: Phone No. © % Zip Code: Fax: E-Mail: L 1" i Phone No Fill in fee simple Title Holder on next pa e ( if different E-Mail State or County License from the Owner listed above) 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: Address: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: Not Applicable Name: Address: City: Address: 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 WA IN TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for imp o ments to your property. A Notice of Commencement must be recorded in the public records of St. Luci unty and posted on the jobsite before the first inspection. If you intend to obtain financing, consult wick der or an attornev before commencing work or recording vour Notice of Commencement. Signat r ner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE FLORIDA STATE OF FLORIDA COUN OF S fit-. 1..X'%,Qp- COUNTY OF Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of X Physical Presence or Online Notarization Physical Presence or Online Notarization this day of uti 20ki by this day of 20_ by Q�a,ca rn�csa4 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 Produced (Signature of No city Public- orl=GIVENSGGIVENS (Signature of Notary Public- State of Florida.�; NState of FloridaHH 086359Commission No. 'AG'S5 e res Jan 28, 2025 Commission No. (Seal) Bondeonai Notary Assn REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 5/6/20