HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: g 1,3 la D � Permit Number:
91ro LUCE RECEIVED
AUG 02
Building Permit Application 202�
Planning and Development Services St,Lucie County
I erimtiQ
Building and Code Regulation Division Commercial Residential v
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: i re 1
PROPOSED; I.MPROUEMENT LOCATION;:
Address: MM Je-�Ceccson T 1CQ\1 O �-� Pik
Property Tax ID#: I H a.g -Ma- I3 a(� - OOO - O Lot No.
Site Plan Name: Block No. -Sq
Project Name:
DETAILED,DESCRIPTION OF'WORK:`J
W6 wk c e 1 a_-l-h
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTIONIN FORMATION:
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 2U6 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE 4 CONTRACTOR:
Name "e.(%be(3-o cL Name:
Address: WO-1 .Ve U,� okW\( Company:
City: F (A - P7 _>!U State: FL Address:
Zip Code: 3q9 q Fax: City: State'.
Phone No.11'�. -y F,� ?a q q Zip Code: Fax:
E-Mail:_ LS y-\ a.S nr, ro-An Lo.Czry,l Phone No
Fill in fee simple Title Holder on next page( if different E-Mail
from the Owner listed above) State or County License
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 MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone 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 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 attorney before commencing work or reco5&g,yaur Notice of Commencement.
AUG 0 2 2021
Signature of Owner/Le ee/Contractor as Agent for Owner
St.Lucie County
STATE OF FLORIDA Permitting
COUNTY OF 5'k
Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization
thisa dayof CNyq 20aA by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced
(Signature of Notary P lic-State of Florida)
5 OE NSA GIVENS
Commission No.,NA 3 ;:� Y ap public State of
=ol,a, Notary HFIOg5359
My Comm.Expires Jar 28.201.5
Bonded through Nationa'.`+ot'--�.+Assrs
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
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