HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO"MRI OMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
e)n gntY
Q UI
- D ' 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:
PROPOSED IMPROVEM;ENT7LOsCATI;ON K°
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Address: lika4%4'AlD S �Cc•e 3 `� �3
Property Tax ID#: 3 Y/Q 5-6 Soo 579 00 Lot No.
Site Plan Name: Block No.
Project Name: cLA
DETAILED DESCRIPTI{QNOFW®�R+K `
S
New Electrical Meter Second Electrical Meter (Affidavit required)
CQNSTRUCT M ION INF0RATIONr
h
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Pond
_Electric _Plumbing _Sprinklers _Generator A-�Rkoof —3& Pitch
Total Sq. Ft of Construction: c Sq. Ft.of First Floor:
to
Cost of Construction: $ ///� , Utilities: —Sewer —Septic Building Height: l o
QINNER/LESSEE _ CONTRACTOR wb _
Name 6 . �,/ /n&C o Name:
Address: A , 1
/2a�G�r N /Pc/ Company: l�
City: Crt State: Address: sW
Zip Code: Fax: City:�OK�� s�e State: ,
Phone No. 7 d — & 7 ` Zip Code: 3 Fax:
E-Mail: Phone N<Z7,A -AI F 5 16f����
Fill in fee simple Title Holder on next page(if different E-Mail tQ f/Vl to
` from the Owner listed above) State or County License CCC 13 3 /3 0�
If value of construction is 2560 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.
SU-PPL1§41),N,TAL�C®NSTRU f®N LIIEN L�C1N IiNFO;RIUTATIO�N "` w ;
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Ph ne Zip: Phon
FEE SIMPLE TITLE H DER: of Applicable BONDING COMPANY: Not Applicable
Name: I Name:
Address: L 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie Co y and posted o the jobsite before the first inspection. If you intend to obtain financing, consult
with a de or an atto n before commencing work or recording our Notice of Commencement.
Signature o wner/ essee/Contractor as Agent for Owner
STATE OF FLORIDA�/
COUNTY OF �7 T� E` /
Sworn tqkor affirme�an� subscribed beforg me of Physical Presence or Online Notarization
this 0 day of u c. 20a I by
Name of person making sta ment.
Personally Known OR Produced Identification
Type of Identification Produced
�r�2cc)
(Signature of Notary Public-Sta a of Florida)
:A�ndrew:G
ry Pblic State of Florida
Commission No. (Seal) Reidyomission GG 347651
j�t~ res 06/2312023,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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DATE
COMPLETED
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