HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0 Permit Number: �Z,y l.0 Q 1 Su
91r° TlLLi UCIlIE RECEIVED
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Building Permit Application JUN 0 4 2021
St. Lucie Couy(y
Planning and Development Services Permittir}g
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:
FROP;OSED`.IMPROVEIVIENT LOCATIONu € ;
Address: F03Y d W , i I've ?4L.-4 Crr k•3'ig pU
PropertyTax ID#: 44237-70 3 ^ Qol DocD "3 1 Lot No.
Site Plan Name: _i _ �,.j��-�P�� Block No.
Project Name: We yj og" o
New Electrical Meter Second Electrical Meter
CONSTRUCTION I:NFO,RMAIION y'
y.
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: - _ — Sq. Ft. of First Floor:
Cost of Construction: $ I-? d10 o . <X'0 Utilities: —Sewer _Septic
Building Height:
Y,
QWNER//LESSEE
CONTRACTOR
Name �e
Name:.
'�2/.l�e�S
Address: fir✓• 9 ��� /
Company: 7� jgd ex—
City: _ ?Ji/t/ rc,s State/°`-
Address: /2-c9c7 JYE . ,Q^ .rD Au.
Zip Code:3YI9`)' Fax:
City: �`�.��-% State:r-llf.-
Phone No.
Zip Code: Fax:
Phone No (�22) Z ZO 2(p 2S—
E-Mail
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License ?pa �%
r
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.
SUPP,LEMEf TAL? CGIIVSTRUCTION LIEN LAIN IN
ORMAT1011
-� �'i `9' V._
DESIGNER/ENGINEER: _
Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _
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 records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attornev before commencing work or recording your Notice of Commencement.
Signature of wner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF /'710�
COUNTY OF
(or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me ofhysical
Presence or Online Notarization
physical Presence or Online Notarization_
Ito
day of 3'u�¢ , 2021 by
this �_ day of JrtaN2. 202g by
e of person making statement.
Name of person making statement.
onally Known OR Produced Identification
Personally Known OR Produced Identificatio
H
e of Identification
Type of Identification
uc d LZGe..-ss-c—
Produced
N 0
ig0
na ure of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
mission No. &Ono3 (Seal).
Commission No. D 6 �63 (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20