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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAU APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED © . Oq 0
Date: Permit Number: �L
RECEIVED
L i.ICGL ` ` 'lJUL 16 2021
._LOW
. `� Building Permit Application s�• Pl.,"�►
Planning and Development Services
Building and Code Regulation Division Commercial. Residential
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address: /� UJ^ l Pc ' --.a
PropertyTax ID #: 7 Q. Lot No.,+2 _
Site Plan Named i ids" Block No. Sr
Project Name: lm(A)
DETAILEDESCRIPTION:OF WORK:. ;
New Electrical Meter Second Electrical Meter
CONSTRUCTI0N INFORMATION
Additional work to be performed under this permit - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters indows/Doors _ Pond
_Electric _ Plumbing Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: - T S Sq. Ft. of first Floor: r� ft
Cost of Construction: $ 9, 1� �Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE ='
.CONTRACTOR;
Name lilt w1
Name: ji 6&2,
Address: 1,1!i e
Company: •-r
City State: —
1
Address: 1•J ills`a 4,
Zip Code: Fax:
City: � State:
Phone No. L I&G l�
Zip Code. Fax:
E-Mail: ` j �.nrv, � p s � � � 1 �Ej Ue.; C"
,off
Phone No
Fill in fee simple Title Holder on next page ( if different
E-Mail •Q1 �. �:-4v► a'yl
from the Owner listed above)
State or County License C, 9�Ci' c.
_J
If value of construction Is Z5uu ormore, a Krr unucu r4mme yr wrn61MAUCu3cna .0 . may..•. ��•
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a perms to a zna wul —low•• •—•__.__.
1 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 authorise 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.
iIn consideration of the n accordance with the approved plansof this rthe Florida uested permit,
ilding Codes and St Lucie Couree that I nty Amendments.
The work
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 ipndpr nr an attorriev before commencing work or recording your Notice of Commencement.
actor as Agent for Owne
STATE OF FLORID
COUNTY OF e_^
Sworn to (or affirmed) and subscribed before me of
o/P ysical Presence r Online N tarization
this day of 20 iby
�i�,/o w, n•� lam. f.J. //, �:.g
Name of person making statement.
Personally Known 3,00� OR Produced Identification
Type of Identification
Produced �!
(Signature of Notary Public- State of Florida )
Commission No. �'"& ";slieolarV Roy of Florida
eslie Roy pruce
%- , �,< My Commission GG 367596
REVIEWS I FRONT I LUNINb aurcrcvw
COUNTER REVIEW REVIEW
RECEIVE
Signature of Contractor/License Holder
STATE OF FLORIQ*
COUNTY OF 9 Ftj-O-► QA d -
Sto (or affirmed). and subscribed before me of
Z�`PPhysical Presence or Online Not rization
this 1 S' day of Su✓ ;by
(A IWP
-90
Name of person making statement.
Personally Known OR Produced Identification
Type of Identifica on
Produced
(Signature
ate of Flo
q,ea
vice 11
GG 367M
PLANS I REVIEW VREVI.EWON � 5EA REVIEWLE MANGROVE