HomeMy WebLinkAboutBUILDING PERMIT APPLICATION�V'b�i l,'. �Subm;t�ls ; Sflv�CtC CU
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
9` Lro CLUcQI�
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t� 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:
Address: ..�o 5 / .-S f
PropertyTaxlD#: 3 (o/
Site Plan Name: /14 e,
Project Name:
- /i,//`f - /// r.L -//(l//-
I DETAILED DESCRIPTION OF WORK:
I�
u
Ll-�'
Lot No. 3 Y
Block No. 7
,132cj-) 1VV1 pc`C-f Q,o�.�e�l q�sc�cl�e dgcsC �Ze
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply: 6 -range 4a�i
_Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors _ Pond
_Electric _Plumbing _Sprinklers _Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 2 f Z 36 e Utilities: —Sewer _Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name S 6)'0- �,re NN e I,
Name: Gi
11 cc+n' ,o.S
Address: ST 5 15 H i C Le- r u 1i ✓ r
Company: lei LL
City: P't. �a a r i � State: IL
Zip Code: 3tI r'r if2 Fax:
Phone No. 640 - 313 2-L
Address: 1R71.Sr e ."c3 -V" 44'co An tv
City: S-F. Loma c .-e State:
Zip Code: -,�gltK-� Fax:
Phone No -7 72--02..0 7-53(j 6 (i
E-Mail /UTA
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail EO6—!r i"'� e ➢vof t-� jg�
State or County License
if value of construction is 2S00 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:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: e:
Zip: lone
City: State:
Zip:_ Phone:
FEE SIMPLE TIT
Name:
E HOLD _ Not Applicable
BONDING COM Y: _Not Applicable
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 records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender qLan_attorney before commencing work or recording our Notice of Commencement.
Signature of Owner/ essee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF 6�. L. JC i 47
Sworn to (or affir ed) Vd subscribed before me of !'Physical Presence or _ Online Notarization
this day of 20_.AJ by
Name of person making statement.
Personally Known </ OR Produced Identification
Type of Identification Produced
Al _�
(Signature of Notary Public- State of Florida)
Srate of Florida
Commission No. 05a36`I (Seal)Toro
on HH 062369
2024
REi
REVIEWS
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ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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