HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO, MUST BE.COI\•, TED FOR APPLICATION TO BE ACCEPTED
/Z43 /22 Z) Permit Number:
Date:
94
p
RECEIVED
Building Perm it.Appl:ication.,
DEC: 2 3 2026
Planning and Development Services
Building and Code Regulation Division Commercial Residential
Per St. Lucing Departmie ounty t
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:,QAj-r 4-K-PgouF_ >~r. -JA.,-r ,
c .'SgX9 m..R �.¢,. Jt 3M1"`lsr•^ sa-s.?vrp�e -ter
wP, R®PS , gI'MPROM NTLyO A�1 <v .:.: t ek .u:•,
....tu
�*`-Cs.er...hi.�.ri.`*'7'^..*,�sfv .n.c.`i..:..:�an e-.j.-eiavt: t-.."..h�y3
Address: t'oo /o �• S l'� may' �v
31'�� ad -Q 6Q -Cp
Lot No.
Property Tax ID #:
Site Plan Name: 1-i 1A
Block No.
Project Name: '50G/AL. s�c�,�,el-ry OrrILt,
IN
�05�
MT L e Sk4*V .4 I o r4 S.
New Electrical Meter N /A Second Electrical Meter fW %A
-
.att_!i4_ �^aa.,.�*u-�.F�2*F��.�a::i'-'bn 13_.s5•trr_'�s:a"'� . x_....�.
Additional work to be performed under this permit- check all that apply:
Gas Tank — Gas Piping _ Shutters _ Windows/Doors
_ _ Pond
_Mechanical
Electric Y/Plumbing Sprinklers _ Generator — Roof
Pitch
_
$%
Total Sq. Ft of Construction: 15 3�? Sq. Ft. of First Floor:
£2C /STD #4 G
Cost of Construction: $ J`-1 5� f7 o a . Utilities: ✓ Sewer _ Septic Building Height: Z Z b
cats:•Fr'is�,,-;7w asj..uyw3� "?'+- � ef"1T* O�._WNER/LES1SE�E``�1',`ONTR�ArC+®�R'
��a�,. °��.. 1a4•w"'.-�'"+�l�tu'�Jra��dli-, �t
.s ?e�i
..E'srid•e4c(.�-1,�•,..ta+a1�34'`!. itv.:k'f�.Y "=:g,:ity,
`J �oRT Si Lke-I� 1.L' Name:Z!5 Tip-Ce1J SUIt�!_25
.4F��iY
Name .� •+
Address: FO, 30'c Iq / Company:
City: Vv% AylSor/ State: FL• Address: 30 15 n° F L A K1_ .
Zip Code:3Z 3 >4 1 Fax: City: 1 "o V 1
State: ILL -
Phone No. a 5 O - 4 73 ie $ 4PL7 Zip Code: 327gG Fax:
E-Mail:�t�'1'1-I IeVL 85 Lr►o�R2Q Phone No �� �-' 3�-z -
d�
GAS
Fill in fee simple Title Holder on next page ( if different -Mail S,aTuePV 8tA It, 04.r2a 10 F �aaR a o
from the Owner listed above) State or County License
OdF S.
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.
[J
DESIGNER/ENGINEER: _ Not Applicable
Name: 44f-y ni &f X 594 Of 405,0 e
Address: 2/!3 5ROA o 5 + .
City: —rrr"S V t rr t-'L State: �c
Zip: 32-?4J Phone 3Z7- 2Ay- 134,&
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
rite
Zip: Phone:
State:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Applicatioh'is hereby made to obtain a•permit to 0o the worn ana instaua❑on d--, MUwaLcU.
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, sigris, 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 t efore the first inspection. f you intend to obtai �inanci consult
with lender an attorn efpr'corprr1enc' g work or recpordi or tice �
re of own eaAessee/Contracto r as Agent for Owner
STATE OF FLORIDA
COUNTYOF%-�.a-�
Sworn to (or affirmed) and subscribed before me of
_ Physical Presence or Online Notarization
this day of 2020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Idenfjcation
Produced I-
(( gaatGre of Notary Public- Stag"of Florida )
Signature of CgrFactor/License Holder
STATE OF FLORID&
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 2020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produc 1
1
(Si ure of Notary Public- State of Florida
;ovSX" LASHAHNA
Commission No =o �' 4c i4A{ NAINGI sGl�N�a:�Ih41NG Commission No. _* • *_ ICOt�MI
MY COMMISSION # GG 275060�. :a'• EXPIRES:
REVIEWS
COUNTER I REVIEW
DATE, - • . .
RECEIVED'
DATE
COMPLETED
Thru
REVIEW
W-015OR I RED W I VEGEREVIEW . I V�1
;# GG 275060
ber 20, 2022
b is Underwriters
REVIEW