HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �rv6.Y 2W,2CaI Permit Number:
p 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 IMPROVEMENT LOCATION:
X
Address: L Z 2 &1 L,5c__ c: id 4 ' A veAt Li 64,—, � f' Lue.lL I=L. 3q 9-6'2
Property Tax ID #: -'-4 Lrl _i"t r) 4 Lot No. ?
Site Plan Name: 13A 1zL & Ld rE,tC I Ala i7s LL— Block No.
Project Name: 1A4S'—,"14L 4214,ll,1l LlAiK l47VLL-'
DETAILED DESCRIPTION OF WORK:
MC, T f OO,- 4 A K a-z r Lt ,_ , i 4J r' Tw LL 3 1 rL � F. �i [= 4/ ` Tit � � CrfNr,rr L l� I—L-Ar ct
1�n10 tN7 Lt5f 741L G"L(< /GNCL:' k.i7F ?fz�-
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
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 Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 4, b 4L:l. r_: )
Sq. Ft. of First Floor:
Utilities: — Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name �iaai rL L �ifitZr=LLCM
Address: f- 2.3 &L Cvccnig 14 iJL ALL)L
Name:
Company:
City: PesLTS"; L uc� L= State: FL
,Zip Code: 34/9Y L Fax:
Phone No. S UL .177.3 710 a
E-Mail: 6A PILCL6 i- 6�_ L Grit
Address: "? 1 M W
City: I nac, .5' LuciL= State: r-L
Zip Code: .3'19"0 L Fax: -1-7 z _
Phone No 172- };C Z OLZ 3
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail #At F<) P A C.u.�7r��L-�%.
State or County License C_ GC.
.a,uW V, 6VI13LI IA6vVII ib covv or more, a KrILUKuku 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: K Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public retards of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an at or before commencing work or recording our Notice of Commencement.
Signature of Owner/ ssee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Sc—, Luc, L
Sworn to (or affirmed) and subscribed before me of X. Physical Presence or Online Notarization
this 2-V day of J U1-Y 20 Zi by
Name of person ma in statement.
Personally Known OR Produced Identification
Type f den ' ' tiort r laced
(Sig c- Fl ich )
�re�/Notaryub �State<o
Commis. 9- (Seal) Watafy Public State of Fbrlde
m Commission GG 829549
_1: Crystal E Nayton
w Expires 1110612023
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5/20/21