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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I Date: �' ��' V Permit Number: I ri L�t`, 91r.E.r FUE_ RECEIVED ~o AUG 2 6 2021 `_ -..9 .Y•. "w` Building Permit Application St.Lucie County Planning and Development Services Permitting 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: ` ii i-i Address: � (o ( N f DLO 4?� 1=� 6 ePe_6 FL_ ?49 9--2 Property Tax ID#: gyp p ©S'P6 600 Lot No.� Site Plan Name: Block No. $(4 Project Name: WLB iT To l? vrav �y STir-J� �tF(a`� �5 Ao"Yo --o i R=5E7 ffE�- dlJ� G i lC,i�L (e�JtiJ (J� wL S _,Alul-) Lyel-c-) AN tt (l2 PL c_ Ityt dDi�i b <<w►�- ©,u �1�� . New Electrical Meter Second Electrical Meter (Affidavit required) -w3` 3-- dr It" •g' �+. + �.�-'a^tom'�J - - rM 110 a,3z: M 110 Additional work to be performed under this permit-check all that apply:. —Mechanical —Gas Tank —Gas Piping —Shutters —Windows/Doors _Pond Electric Plumbing —Sprinklers —Generator Roof iZ Pitch ,w P F � Total Sq. Ft of Construction: 2 300 Sq. Ft. of First Floor: Cost of Construction:$ $C©` Utilities: —Sewer —Septic Building Height: <a>?- �- ..•: yy-- r1T� r - 1 F 9 Name e (2A. V_(�r�� '�bcv1� Name: �y�=lam Address: Cs(o& -fAr,36Ct-� -_vtZ Company:" CkS 61v Cz scab a� ILL City: t l �t.ceG� Stater Address: 3Z-It ALOE Zip Code: Fax: City: F- Q,Pp� State::F l_ Phone No. 7'7"Z 2Ll.b -3-733 Zip Code:3N R S 2 Fax: E-Mail: Phone No 7-72 Z.\e, A`04-1 Fill in fee simple Title Holder on next page ( if different E-Mail C A;,5.-oN&LAwA (,boo Fwe W 6'°tm,, a > from the Owner listed above) State or County License �/'f r155 S73 1828 of 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. 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 another non-residential use WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for improvemeri_ts,to your property. A Notice of Commencement must be recorded in the public records of St. Lucie Cou a p d on the jobsite before the first inspection. If you intend to obtain financing, consult with I er or attor e before co mmencing work or recording our Notice of Commencement. Signature of wn ontractor as Agent for Owner STATE OF FLORIDAJL q COUNTY OF Swo to(or affir ed) a d subscribed befor me of _Physical Presence or Online Notarization thi day of 20 by Name of person mak7OR ment. Personally Known Produced Identification Type of Identi 'catio oduced (Signature of Notary Pu lic-State of Florida ) Commissio I. R S. NIELSEN a<<';State of Florida-Notary Public -* *_ Commission #GG 207464 %9,F oe My Commission Expires Of F� REVIEWS Y FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev S 2 21 I