HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE C'&i,,"-TED FOR APPLICATION TO BE ACCEPTED-
Date: Permit Number: l v
Building Permit Application
Planning and Development Services
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:
Address: co q
I7 W--e ✓ Or
t-rc e
Property Tax lD #: (3 3 K
- 566 - 6oy(
Q ae), CI
Lot No.
Sit) n Name_
Name:--
Block No.
J4ject
DETAILED'DESCRIPTION`OF:WORK,r���;°
s s
w ti rr<w�rhy
r 1��-�,ll
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION tI-,'
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: r`�') Sq. Ft. of First Floor:
Cost of Construction. $ �� Y Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: r° i
CONTRACTOR:
¢'2�":.
..�
Name eCFe`i �'Jv-y+NKOh
Name: ABne-
Address: �,4u e®h t der Dr
Company: �G�SiS �DoIS
OGf�''�
Address: &65 cit" S+
City: rc a State: �FL
Zip Code:"Code:-31 45 1 Fax:
City: Ve fo Z&Lc h
State: �-
Phone No.
E-
Zip Code: �Ja.�6a
Fax: -770- ` 5G7
Mail: • o To N �a a'� GfMUt� i , e0"-N
Phone No -771 -a X
Fill in fee simple Title Holder on next page (if different
E-Mail -OILS 1-5 Poo Is q
cc Wi
from the Owner listed above)
State or County License
�. 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. ,
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SCtfi?PLEMENT,AL CONSTRU t 11;07 LIEN Ll�►Ut% I
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DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY:
of Applicable
Name: 5K, I &qi reaCiry SKyites %v%c
Name:
Address:
_
Address: 9-4 31 A I oV%(A ANAE the tA4
City: W �%Y'N}e.c Woot K State: Vi,
City:
State:
Zip: SA-7 9L Phone C40-1) 2-?S - 10 14
Zip: Phone:
FEE SIMPLE TITLE HOLDER: of Applicable
BONDING COMPANY:
of- pplicable
_
Name:
Name:
_LP
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 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 your Notice of Commencement.
Signatur f Owner/ ssee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF in i an N ty,
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this 2901day of JILTNe , 2021 by
Name of person rhaking statement.
Personally Known OR. Produced Identification
Type of Identification Produced__ _FL_ O L
(Signature of Notary Public- Stat4 of Florida )
Commission No.66 2A120- (Seal)
REVIEWS FRONT FRE
ING
COUNTER EW
RECEIVED
DATE
COMPLETED
P4 CHRISTINA S. HOWELL
MY COMMISSION # GG297262
„ EXPIRES: January" 31, 2023
SUPERVISOR PLANS I VEGETATION I SEATURTLE I MANGROVE
REVIEW I REVIEW REVIEW REVIEW REVIEW