HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED '7 % �-
IIDate: ?" Z 3-t I Permit Number: � /0 / ® /
1�lyo RECE
IT, °' ° ° Building Permit Application JUL 2
Planning and Development Services /' Fermi
St. Lucie
Building and Code Regulation Division Commercial Residential w/
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 335 S TiZA'l J • (1 a lgdf, , P.L ,,
Property Tax ID#: 0 -813 jZ - 000 -2.,
Site Plan Name: f4I 1
Project Name: N k
DESCRIPTIO.NOF WORK:
s_ T)__l ...L.
I a A
New Electrical Meter Second Electrical Meter (Affidavit required)
"CONSTRUCTION INFORMATION:
Lot No.
Block No.
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: $ L - Utilities: _ Sewer _ Septic
Building Height:
'OWN ERAESSEE: ..
CONTRACTOR:
Name 90".-E a- :1 axes
Name:Jf-7 rA P 13/'ds c{9ojaiz
Company: Yi S6o
Address: f- TAALI 9 Q;(/*V'
Address: 7 6 S & WMf A&kk&,-Oe. A,
City: )S L Statee
Zip Code: 3q"!_� Fax: 3 ' ?ZZ
City: S State: Ef
Zip Code: 3yq Y3 Fax: 1014
Phone No..'�� 9L � � ��
E-Mail:
Phone No 3
E-Mail 33 aU5
Fill in fee simple Tit a Holder on next page (if different
from the Owner listed above)
State or &unty License 2SSo
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.
2021
SUPPLEMENTAL CONSTRUCTION LIEN 'LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address: I
Address:
City: to
City: State:
Zip: Phone
Zip: P one:
FEE SIMPLE TITLE HOLDS : t Applicable
BONDING COM A Y: 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
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie C unty and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
witKende-Nor an attirney before commencing work or recording your Notice of Commencement.
OF FL
IY OF
ctor as Agent for Owner
mot_.
Sworn to (or affirme nd subscribed before me of _ Physical Presence or Online Notarization
�/
this !L day of h 20-&by
Name of person making statement.
Personally Known OR Produced Identification ✓
Type of Identification Produced a
(Signature of Notary Public- State of Florida )
State/
\��RYP�,� HEATHER BURFORD
Commission No. (Seal) =o�" BState of Florida -Notary Publi
Commission ff GG 183217
=• ires
My Commission Exp
February 09 2022
REVIEWS I COUO TER RNT OEVI NING W I SUPERVISREVIEWORI PLANS REVIEW I VREVIEWON S REV EWLE I M EVIEWVE
DATE