HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: AUG 112021
Permit Number:
SL Lucie County
014
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:
GAO
PropertyTax ID#: 3 l(242 - ( -7-®0Z? , 000 cU Lot No. _yg&�'
Site Plan Name: iaVO►Yll'1(, b a Block No. _
Project Name:
New Electrical Meter Second Electrical Meter.
u'g,4� a
CONSTRUCTIC►NINF�RMATIC},N. �
Additional work to be performed under this permit- check all that apply:
)(Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
X Electric )L Plumbing _ Sprinklers _ Generator %- Roof Pitch
Total Sq. Ft of Construction: 3, 011 Sq. Ft. of First Floor: a o L-is
Cost of Construction: $ 1(03, 000 Utilities: —Sewer , Septic Building Height: 1%5
Na
Address:: ZS W9 NW Leu'1 Ur
City: %('� St " C i P_ State: FL
Zip Code: ?Bg8(o Fax:
Phone No. 07a) Say - 9447
E-Mail: MCIendCO(iv evnhco.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: JQ50r1 lY1eVPiJT
Company: IN7 BL-1iIdeM
Address: QS1 sw Biamopme_ St
City: 'Pbt St Luicie Stater
Zip Code: 64 q B3 Fax: '7 - 344 -94i 01
PhoneNo77ol'3yy" 9400
E-Mail em 11 c pcomcaghll ei-
State or County License CCC 15179 (owl
If value of construction is 2500 or more, a RECORDED Notion of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
2-�0
DESIGNER/ENGINEER: _ Not Applicable
Name: 2pl&1] \461^ `np_
Address: M54 SW bilAyyinA 114
City: %M 5- UA61e State: t L
Zip: B49T4 Phone 77gigSpA
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
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 recording your Notice of Commencement.
re of Oyi'rner/ Lessee/Contractor as Agent for Owner
STATE OF FLORID
COUNTY OF
Swor or affirmed) and subscribed before me of
Ph�hysgical Prese or Online Notarization
this �iay of 2020 by
Name of person makin atement.
Personally Known OR Produced Identification
Type of Identification
-(Signat4re oCtai
PIEM11 a 1 KERRVTOTH
/ Notary public . State of Florida
Commission (yji)ssion N HH 062221
My Comm. E,cpires Nov 9, 2024
a d4d thtouib National Notary Assn.
REVIEWS I FRONT ZONING SUPERVISOR
COUNTER I REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLET
4�, aiA:
S' t ure of Contractor/License Holder erATE OF FLOIMPA
COUNTY Or
Sworn or affirmed) and subscribed before me of
Physical Pre nce or Online Notarization
this IL day o 202T by
Name o person makings ment.
Personally Known OR Produced Identification
Type of Identification
Produced
Of
Commission No.
PLANS I VEGETATION
REVIEW REVIEW
Ndaq Public . State of Florida
Commission a HH 062221
MY �Pm tt
d pires Nov 9, 2024
t National Notary Assn.
SEATURTLE I MANGROVE
REVIEW REVIEW