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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAII`APPLICABLE INFO MUST BE CC+,;ri 'JED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 4�_ VH ��. [LUCE Z2 RECEIVED O Building Permit Application AUG 2 7 2021 Planning and Development Services St. Permittin Lucie in Building, and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION:' .I Address: 13 �7 'I ec. r ��etc.� Np �i�;a ✓� i� :5/�;S Property Tax I D #: "Y p�©� ��� J�CD�C1C� Lot No. Y(O Site Plan Name: Project Name: DETAILED DESCRIPTION OF WORK: Block No. o -C&-ca ' ® Vf 30 606 si t5clvo F5W_ -/ 6kd New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additional work to be performed under this permit —check all that apply: _Mechanical L Electric _ Gas Tank Plumbing —Gas Piping _ Sprinklers Total Sq. Ft of Construction: � Cost of Construction: $ '�! 0 (Affidavit required) Shutters _ Windows/Doors _ Pond _ Generator _ Roof Pitch Sq. Ft. of First Floor: Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Name: Company: Address: 10 37e o- Plaest, City: r) n 5'a ,%J L, FJ e c State: Address: Zip Code: '?3�19 2:7 Fax: City: State: Phone No. r9Ca ` S e1 / E- Zip Code: Fax: Phone No E-Mail Mail: r�hr cz� %� 5� l° A+1— - ne.4- Fill in fee simple Title Holder on next page (if different 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 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: ZNot 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 conflicts with any. applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Homeowners 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 our Notice of Commencement. Signature of O ne / Lessee/Contractor as Agent for Owner STATE OF FLORI A COUNTY OF Swor or affirm d) and subscribed before me of Physical Presence or Online Notarization this day of 20al by Name of person making statement. Personally Known OR Produced Identification Type of Ide ' ication Produced 1 I A A '�� a_ -I I Lt��� - (Signature of Notary Public- State of Florida) Commission No. (Seal) ,�y;- KAREN S. NIELSEN .+++pPY P�Bii a° p= State of Florid Notary Public _' *e Commission # GG 207484 '�OF F+°PO+` My Commission Expires F,a m `++` J u REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5/20/21