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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST-BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 9-7.E C EIS RECENEd r AUG 2 3 2021 t. Building Permit Application st.Lu©IaCounty Planning and Development Services pottll"Ifip Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Address: k A F C", IIz.- -i l� Property Tax ID#: o? -I 1-7 0190- ow -3 0 Lot No. Site Plan Name: Block No. Project Name: ��n-e cnnA q�SO q la�� o?er\tng C-ia-a-e cVatn IINV-, CA & OPeotng ©,, 0Ave - S IAA- o;-, PI-CW4y a rid will SLP cad Coun ;o,- CLISO New Electrical Meter Second Electrical Meter (Affidavit required) �� ­]%g Ion .. _ Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank —Gas Piping _Shutters Windows/Doors _Pond _Electric Plumbing `Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft_ of First Floor: Cost of Construction:$ ��r Utilities: —Sewer _Septic Building Height: "FSF .ems •_ 'KAZ Name o,,r4 cnaJ"'Sj_ Name: Address:3)O /\4 LA J C, �f , Company: City: YEA , R Ci;'C e- State: Address: Zip Code: 3 ), Fax: City: State: Phone NoMa-67a-(_�l 7Zip Code: Fax: E-Mail:75?V�0.nc)Trs36619v nAo,, Co,-), Phone No Fill in fee simple Title Holder on next page (if different E-Mail 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 . 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: 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 an 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 our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner d� STATE OF FLORIDA COUNTY OF— C Sworn to(or affir ed) and subscribed before me of Physical Presence or Online Notarization this Z&-day of 20& by Name of person making statement. \\��pY Fv KAREN S. NIELSEN Personally Kn wn OR Produced Identification �" °\\�� Stata of Florida Notary Public Type of Zen ' ication Produced = lJoa Commission # GG 207484 7 ;1"`�011�+� o� My Commission Expires June 12, 2022 Signature of Notary Public-State of Flon a) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 2 21