HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED allos-c)S �
Date: 5 Permit Number:
RECEIVED
Building Permit Application MAY 18 2021
Planning and Development Services Psrmltting Department
Building and Code Regulation Division 5t. Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982 I/
Residential
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT TYPE: �, W\ *\ d-f\
M
Property Tax ID #
Site Plan Name: _
Project Name:
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. S . v\ C C2A C Y
Additional work to be performed under this permit— check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters
Lot No._
Block No.
Windows/Doors
Electric _ Plumbing — Sprinklers _ Generator' • _ Roof Patch
Total Sq. Ft of Construction:
Cost of Construction: $> � d 0 D
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic
Na s . %n� r v "�
Address: C a nr\!� P n
City: Q 1 eY Ce State: FL
Zip Code: 3 c{ q �% Fax:
Phone No.( l � '"f s1- Nq9
E-Mail: CCa10 °I
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
'Na7gvlV
me:
Company:
Address:
City:
Zip Code:
Phone No
E-Mail
State or County Lice
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
Building Height:
Fax:
State:
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OWNER/ CONTRACTOR AFFIDVI I : Application is hereby mane w UUW111 o
I certify that no work or installation has commenced prior to the issuance of a permit. ;
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
structure. conflict
lease consult withp olur Home Owners AssAssociation
ciation aO drreviewyyour deed for any restrict that
which maor
apply obit such
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE .DOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
F COMMENCEMENT "
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDII
NG Y�?! �R NOTICE O
Signa ure of Owner Lessee/Contractor as Agent for wn r
Signature of Contractor/License Holder
STATE OF FLO IDA
STATE OF FLORIDA
COUNTY OF 5- t•uc'�e-
COUNTY OF
The forgoing instrument was acknowled e,d before me
The forgoing instrument was acknowledged before me
20 by
this\!�k day of Vys9q$ 2_1 by
this day of
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identifications
Type of Identification
Produced
Produced L-
(Signature of Notary PuNlic- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. �c�p3(Seal)
Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION SEATURTL'E" MANGROVE
r REVIEW REVIEW
COUNTER REVIEW REVIEW
REVIEW I REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.