HomeMy WebLinkAboutBUILDING PERMIT APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
ddress: SSf Oy K&; ✓ti-h-z/- 'I
Residential
Property Tax ID #: Lot No. -
I_
Site Plan Name: Block No. -Ao
Project Name:
DETAILED DESCRIPTION OF WORK:
Er..mN
New Electrical Meter 1)0 Second Electrical Meter
CONSTRUCTION INFORMATION:
3'L-2
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Pond
K Electric A Plumbing _Sprinklers _Generator w Roof Pitch
Total Sq. Ft of Construction: o 139 Sq. Ft. of First Floor: T1
Cost of Construction: $ �—�1p3 Utilities: —Sewer J_Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name- C_kwleS )Jtk*✓1
,A1
Name: _T � A.
�rvu2a-
Address: S4V o'x- go-ir *I"- Tg.0 i I
Company:
p Y �i1..- r�YLo--
J
City: Fix--- Pie.-ec- State: V•
Zip Code: 3yq Pa- Fax:
Phone No. 1'i 2 y�5 ' q3�
Address:_ Sit Sk-i
PSG IL1c(
City: _Part- Sk- L,.GI"C State: PL
Zip Code: 314q 5'5 Fax:
Phone No �j�Z- 33Ce -'� U's3
E-Mail: I„y1e,") WN 0) IxIIJO'ti► rl-L
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail a ��
�W.II ee-J, iAw-
J
State or County License CAI
SaH�13�('5';M'13ci
•-`"'�••- �• ��••��•�aa.uv�� �� &awv vl IIIVIC, d nrt-unutu IVouce oT LOmmencement 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
Name: Z>. efS
Address: 510J_
City: State:
Zip: 3A-A-q Phone gLit
FEE SIMPLE TITLE HOLDER: ,Not Applicable
Name:_
Address:
City:
Zip:
Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: — Pdol Applicable
Name:_
Address:
City:_
Zip:
Phone:
%J VV IYCn/ �-VIV I MAL I UK AFFIUV I I : 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 lendier or an-attornev before commPnrina wr)rk nr rprnrrlina "ni it Klr%ti. p -f
-- -
Signat r of Owner/ Lessee/Co tractor as nt for Owner
Sign re of Contractor/Lice e older
STATE OF FLORQA
STATE OF FLORIDA
COUNTY OF-L.,..- ,.c..
COUNTY OF S4. U,,.,c.ore,
Sworn to or of ' and subscribed before me of
Swor to (or affirmed) and subscribed before me of
ical Prese Online Notarization
sical Presenc r Online Notarization
this 12 day of 202� by
this day o 2021' by
AA /
Name of person making statement.
Name of person making statement.
Personally Known �[_ OR Produced Identification
Personally Known �_ OR Produced Identification
Type of Identification
Type of Identification
Produced
±. 14A�� ,
Produced
(Signature of ry Public- Stge of Florida) Kelly Fin
(Signature of ary Public S ate of Florida )
SAR A
Commission No. K'1 C)$ od SO S °c+ Notary Pub
rl (a s FI
Ic �{ O S a Sam S A Kelly Finle
i&mmission No. ( e
State of
y "? Comm# H
082506 `'off Notary Pub'
�� - of FI i
cE �9 Exp res
L - r Comm# H I
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLEysi
YVCl1i&1! in
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
An C