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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: M10 Z/ 01IA4— Permit Number: ®Joe � '� �• RECEIVED O r. Building Permit Application SEP 10 2021 Planning and Development Services St.PermittinnLucie nty 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: �L u PR� OSED IIVPRi?NEMEVT'Lt7CATION .? ; Address: Property Tax ID#: 3 `l S — J 6/ — 0 03 9 — 0 2 Lot No. Site Plan Name: Block No. Project Name: lDETAILED 17ESCRIPTIONsOF o.F= .r.w b t'h ' ;�t•>. , ` k�.: > /2Gt�tOc�C f cx o,� TG�2 L�.� s c7 ,0 C 13�X 0 i/ _S e�P New Electrical Meter Secon Electrical Meter (Affidavit required) CONSTRUCT.ON IN1=4R[VIAT�ON r r u �.t t,r>z*�tiYn„� .. Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank y;:, _Gas Piping _Shutters _Windows/Doors _Pond Electric 't"Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ �J�•D o` Utilities: —Sewer _Septic Building Height: f dS' � 7a jr Y�pY 1PT��r 4 }•f, ; '" y�kf�V�Ub k� 5 twF W� � �" Y }}1 h Nr f rk } i�{J 1 OVINER�LE�SE k k b. v, n = CONTRA rOR ' �b Name,5,4 //7S CN (_--Ue 15e S Y f „/t4C Name: )i74G Al-. 4.,o P.L—rT-O Address: f 2S'-SS- 3 is C4MA;C-- BLu_,) Company: s: llLli Lt1 iJ � ,4,.u3 City: olc%/f tym-m i State: L Address: 04 1 Zip Code:_�Fs I Fax: City:Po le—I Sd"t e a State: . Phone No.30 �1' 33 7Vy7 f 2� E- Zip Code: 3V 9'7 Z Fax: Mail: Phone No 7 72.- 220 — 75 77 Fill in fee simple Title Holder on next page(if different E-Mail 114F0 P C2 P z) , PCUWd 1/y from the Owner listed above) State or County License_Ct;C /Y 3 © 2- 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. I }i:?'�°v y£'r! n fi;<.,c >a.4 �s.I ,+,;rr,'� 7..}st,i r{ianr ya k.y,r ti;: n�.;.i u,Y•lro a a't . .4:�N,uuvsx•zr, „i: , U4;?C{,;..tit 6 'h,,. :e..,.r,{. ,{!r' ;,.'r :i€�A L,Y•s.s,��,ar'{ +•..:tir,4 iW1.."VeV�I 11JE: a '{r r `Tab I r t r n i l P r Sirj�us ti fP yral ) fiFk'5��§ S,ri 1 S 3 .5,.. v d; 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 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. _*'11 r_,c_ Signature of Owner/Lessee/Contractor as Agent for Owner STATE OF FLORIDA ! _ COUNTY OF (,�A. SworQ tR(or-affirmed)and subscribed bef$re me of Physical Presence'or Online Notarization this day of 29EA by Name of person makindstatement. Personally Known O Produced I entifica 'on Type of Identification Produce (Signature of Notary blic- tate of Florida) is Commission No. (Seal) ;a°n :�'.rPy AUDREYB.HUMPHREY :�: :*: MY COMMISSION#GG 300817 , EYE EXPIRES:March 6,2023 i rFOF c°� B onded Thru Notary Public Undemn"t, REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev