HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COM WEED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:40 �V�07b
Y RECEIVED
Building Permit Application JUL 2
3 2021
Planning and Development Services St.Lucie County
Building and Code Regulation Division Permittino
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: �cp�ij1�
Address: ro�v�P A/uv V+t-Oh v S
Legal Description: bF44-1;mo,,i- 4-e //y wo 001( .p I
Property Tax ID#: LI 4 Z0 - 1 Yd - 00 1 2 - 000 ? Lot No. L�
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
ON OF WORK tTAILEU :
ago C� -�✓�xv: �t� , - u-1a �7 S(mac-�-e� -�- Ca�•4�.,, !��
ox a �Q Q., z L" l/
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _ Plumbing _Sprinklers _Generator _ Roof
Total Sq. Ft of Construction: 50 Sc t' Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer _Septic Building Height:
O)W ;
Name k C et fl Name: �o
Address: (� 5nn c/�11n I'� Company: (a"S
City: cbS State: Ct Address: �/. Z....
Zip Code:QG T Q 4 Fax: City: 1�5� State: rL
Phone No. Zo' 'S ' Y7 3 Z Zip Code: 3`f ST3 Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page ( if different E-Mail: /(?Jt►2-';�)6�2- LJ G ter't-
from the Owner listed above) State or County License:
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. � J
DESIGNER/ENGINEER: of Applicable MORTGAGE COMPANY: of 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: 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded 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 recordingour Notice of Commencement.
le" (a-
Signature of Owner/Agent/Lessee/Contractor Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5 k. COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of ! An 20�M by this day of 20_ by
-e
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary P ic-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
^�" r DEONA GIVENS
Commission No� �Cro *�• Not# lic State of Florida Commission No. (Seal)
co"r.issior d HH 086359
�cf` µy Comm.Expires Jan 28.2025
Assr.
REVIEWS FRONT O'NI NG SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
-R—ev-. 7/2014