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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE l vvfiPLETED FOR APPLICATION TO BE ACCEI j' Date: �:� % Permit Number: RECEIVED Building Permit Application MAY 0 4 2021 Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 P©rmittiatg DAPnment Commercial Residential `u�iev PERMIT APPLICATION FOR: �,�,�j y S• PROPOSED IMPROVEMEENT LOCATION: Address: SwnIr: s:z ' I Property Tax I D #: Site Plan Name: C&tprf Project Name: ( I Lot No._ Block No. DETAILED DESCRIPTION OF WORK:, W L uw for.,, a..a. doer a .2&x 21 4" isc.K CL6 6,!4L 12'' J1& 2l fi%I... — 3&X 13 ".ha . a.,,L c, r9' L,IAe— St . L,JIC o.!/ y1151-56/t �74, 8" lig 6,,,c, & w:!/ g000 ,os:, tr: b-c.e iu.Ls�• . dliY - B� yo-im r•e New Electrical Meter Second Electrical Meter S ' j,&,tYL re' CONSTRUCTION INFORMATION: Additional work to be performed under this permit— check all that apply: _Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond Electric _Plumbing _Sprinklers Total Sq. Ft of Construction: �Z 0 Cost of Construction: $ 000 Generator Roof Pitch Sq. Ft. of First Floor: Utilities: _Sewer _Septic Building Height: OWNERAESSEE: CONTRACTOR: Name /`1 i Clams % Ra 1 cPtL Name: Address: $1 hf: S-e.- 01, Company:-,!�TC. C-pnC1fji-tw�-L- lL(- nn5u City: FY I".�/ c t State: Address: $ZSO GC CA..a ( P-1 Zip Code: 341 `I S Fax: City: Port SF L>, State: rL Phone No. Z72' 4 7 ZSf 2 Zip Code: Jq9VI Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page (if different E-Mail ZTC. Coy,%u e+e.. Pl- S 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. r���3,� A ;V�'',. �. � 3 �� ,� +?y� �rh �, .. �,J�y�� k"Y+�t�•if��� ���aa�l'�)�,+.�e rylt'a �J�, ifs,fi�t{'r,�'r!'� (:1,�.d`3�Sj� .—"Y .: �t:.� �+�e,�y.+G,,L.s�:�2�`.�;!k"Ek l .. �+1'6uit'i.�. �.�>ti 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: Apalication is herebv 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 Countyend posted on the jobsite before the first inspection. If you intend to obtain financing, consult %n,ith lanrlo r nn-attnrnav hafnra rnmmpnrina wnrk nr rpcnrdine vdur lra ice of Commencement. Signatur f Owner/ Lessee/Contr ctor as Agent for Owner Contractor/License Ho =FL,ORID STAT OF FLORID COUNTY OF &777V COUNTY OF Swoln to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of ,01 Physical Presence or Online Notarization P y ical Pre nce or rday Online Notarization this day of bee , T_ , 36�by / this of g4e dui 2 2"y / ELT C P-0 it C r_6 oyey 14 e Name of person making statement. Name of person making statement. Personally Known _.::L�_OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary P Iic- State of Florida) (Signature of ? � ; •$ :: AUDREY B. HUMPHREY MY COMMISSION#17 Y P� Commission No. o.� .. ��: AUDi2EY HREY Commission N OMMISS G 360817 g,,,,,,,�, /� EXPIRES.March6,2023 ,��e'�, EXPIRES: March 6, 2023 EXPIRES. 8�nded7hfU PuNkiJ,d hers REVIEWS FRONT SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE ZONING COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Kev. 5/ b/ LU