HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COM'�Le i'ED FOR APPLICATION TO BE ACCEPTED
Date: (� ' 7 ' Permit Number: J
RECEIVED
® JUN 0 4 -2U21
Building Permit Application -
Permitting Department
Planning and Development Services St. LUC1_ eSeurltY
Building and Code Regulation Division Commercial Residential 1�
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: qy'`'1i C� �• �L✓
Property Tax ID #: 3 3 ��' �Q l-' QQ `� �f -Dav- 3 Lot No.
Site Plan Name: P/�MSOAJ 9`C��1� �iJ Block No.
Project Name:--1l-177-
DETAILED DESCRIPTION OF WORK:
MOON) Ty EYl ,� 7746-� MAZ
New Electrical Meter Second Electrical Meter U
YS '&t-tP.5C u(C'
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
V/Mechanical _ Gas Tank —Gas Piping _ Shutters ✓ Windows/Doors _ Pond
V' Electric V_ Plumbing _ Sprinklers _ Generator ✓Roof Pitch
11
Total Sq. Ft of Construction: 91171 Sq. Ft. of First Floor: _
Cost of Construction. $ iy, I 00GI Utilities: _ Sewer _ Septic
Building Height: /R'' �
OWNER/LESS'EE:
CONTRACTOR:
Name BenwW )_Y I t)
Address: 7AII SAA/ft- t+65- /M
City: p(�?2�c4� L!.!('if� State:f>
Zip Code: r Fax:
Name: rjdRw/
Company: o!5� C1164r&S 44e
Address: l)&O
City:YaLl-rf-16616;_ Stater
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Zip Code: Fax:
Phone No
E-Mail (, 1 d416-/�-Y . ' a,77Y, ti0--
State or County License GCC_/5aC;Z_/may
If value of construction is 2500 or more, a RECORDED Notice of commencement is requires.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
,SUPPLEM,ENTAL.CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: Llej+11-5i lkoftL [14Le A
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: MS 1U�A?2lfxJ,T�` "P
Address:
City: Lu ac, State: F
Zip: Phone L%J�
City: State:
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
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 attornev before commencing work or recording your Notice of Commencement.
� Lt�al�
Si ature of Owner/ Lessee/Contractor as Agent r Owner
Signature of C tractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA '
COUNTY OF
COUNTY OF
Sworn to (or affirmed) and sub abed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
v P ysical Pre ce or Online Notarization
29i0'6y
this day of 2020 by
this day of C-;i
statement.
Name of person king statement.
OR Produced Identification
Personally Known OR Produced Identification
/ofpersoaking
ionType
of Identification
Produced
es3���m
(Signature of Notary Public- State of Florida)
(Signature of
Z�N� Fed'• AUDREY B. HUMPHREY
Commission No. (Seal)
Commission
_. h7YC0MMISS1ON#GNgf 7
PR S: March 6, 2023
Bo^drA Thru Notary Public Underwriters
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
I.Y. Pik
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE'
RECEIVED
DATE
COMPLETED
Rev. 5/6/20