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Home My WebLink AboutBUILDING PERMIT APPLICATIONAll 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 Residentia 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1S78 PERMIT APPLICATION FOR: L (� �h• c�� 1 fPROPOSED IMPROVEMENT LOCATION Address: I159 k-44 r ,-, z, C< � - , -cam f,. ��^U •.2c.}� `jY�c._ri-e- I Yl iC c'rr-�rY, c,l C2 ls-vv.avFS Property Tax ID #: a_ - C 1 - 1 --L>o c _ Lot No. Site Plan Name: Pi" a Jc�s .� Block No, Project Name: 'Prr-U"� cl .a DETAILED DESCRIPTION OF WORK: ,�—=- • •- — V- ' r. T r-: J r, 6, if I 'I S ti New Electrical Meter Second Electrical Meter ECONSTRUCTION INFORMATION: Additional work to be performed under this permit - check all that apply: (Affidavit required) _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Cost of Construction: $ Q , Z c>O , ©C> Sq. Ft. of First Floor: Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name- eif,-- �' c 1 o �,- L,?`, t- Address:JD- moo,- Z�eS _�>uv— City: 3 c] C_ h CL t-,c 1 0- C_ G C State: Zip Code: Cetr a ca cc_ Fax: Phone No. S 8 1-9c)i1- -2- E-Mail: yr + • Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: Company:::",w� '�3Yz,L�1 CLA �T ii� L Address:3 �)S Y)t 5.A, y.e City: CA-_ State: } Zip Code:. �`-V �"7 Fax: �,-� 1 - -�ac�- u , Phone No cagy ' y �v - c s'3 3 3 E-Mail S LV3c� r State or County License �Y 3e, f s° 11 value of construcnon Is zSuu or more, a KtLUKutu notice or commencement is requires. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL. CONSTRUCTION LIEN LAIN INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name:_ Address: City: Zip: Phone State FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: Citv: Zip: Phone:_ MORTGAGE COMPANY: Name: Address: City: Zip: Phone: BONDING COMPANY: ~ Name:_ Address: City:_ Zip: — Phone: Not Applicable State: Not Applicable 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 p,•ohibit 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. gnature of Owner/ Lessee oritractor as Agent For Owner STATE OF FLORIDA I COUNTY OFF Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization this t''rday of A,) c" ,, sy , 202L by Name of person making statement. Personally Known �—OR Produced Identiflcatlon — Type of Identification P—roduced 1 1 u►- , t 4 rt � -t>r ,k Lvs I (Signature of Notary Public- State of Florida ) Commission No. GC. !�y 1 001 (Seal) FRONT ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED ...... y KAREN CODERRE MY COMMISSION N GG U1001 s. EXPIRES: April 23, 2024 'T'•q. n!� Bwww Thru wary hbk underwfters SUPERVISOR REVIEW