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HomeMy WebLinkAboutBuilding Permit Applicationi r' .. All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: O Building Permit Application RECEIVED Planning and Development Services 5 2021 Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 p;rmitt�ng Department Phone: (772) 462-1553 Fax: (772) 462-1578 5t. Lucie Count• PERMIT APPLICATION FOR: Address: 3Ze> d Property Tax ID#: gO1-00G0 — 000/0 Lot No. Site Plan Name: `2�%i%�o�,�"dn� /�%�il,® '4*1-e— Block No. Project Name: New Electrical Meter Second Electrical Meter Additional work to be performed 1VMechanical Gas Tank Electric Plumbing under this permit — check all that apply: —Gas Piping _ Sprinklers Total Sq. Ft of Construction: / 3 66 S:F Shutters _ Generator Sq. Ft. of First Floor: Windows/Doors _ Pond Roof Pitch Cost of Construction: $ 9', 9d J Utilities: Sewer _ Septic Building Height: '•t.�r �?-.� :- t' r jgtl c }i nI'y.. rs �.� �. - a . ` C 'ii. X"n �"i Tip a#OWrNGEIR/�LEaSSE�E r v rr r'- n, S.� �" k :y yY4 7 L �5•"r� r rr F�``„;;, J 12D�, N7p.:i 11. D.;� S+'. ,. .�1 1.4...Y.. .1.- .Y-!f•�, u4TYv _Ca_. ;.!.3rj' '..t i .i _r .� 5�.. f. :'YL. NameeV�m &a,�qv rjo,. Company:Pi�� Address: Address: j 2�©' �'�. /off' City: A;zfiz ran 'z State: City: State: Zip Code: 3S/!20 Z Fax: Phone No. 7Yy,2 7 ,Z :5 — 3 E3z-,/z-5 Zip Code: Fax: Phone No i .7 Z)9? Z - 1'151 E-Mail�,���P%,'-r�.,� E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) State or County License r i-4Z//%31 3,�< 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. ,-_.,;r ., .i. j J A-si-9;+E ,_,.��:F-.—,:••Z-�.- . .; LgWINaFORIV1gTrO,N,�� } t_. Y''+2., T NVF 3 as f r p =SUPP,LEM`EN}TAL.CONTRUTIONILIEN ,52p,d s vy� 3, Fr ? vat. r'�. f ikt. �i+?' S��.,�CE+�?:.u:'r 7 .Kyl .'ter r ,.�.>'� `'�a� 1.�.si`�4^.a... �xit:'�.a; +DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: S�7 cez& Name: Address: 5'0 5 uA�A— Address: City: State: ,�� city: .S4 Z&rhy- State: L ,IPo4� Zip: Phone 7 7Z) R 3•,R— ?' 7ZY 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 ana inSLd11dL1U1I db 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 structure. Pleasle consult vUith your Home OwnOwners rs A sAssociation c Association landrreview your deed for any res Actions which maor apply obit such 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. i Signature of Owner/ Lessee/Contractor as Agent for Owner I Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization this day of 2020 by STATE OF FLORIDA 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. I Name of person making statement. Personally Known OR Produced Identification Personally Known _ Type of Identification OR Produced Identification Type of Identification Produced Produced (Signature of Notary Public- State of Florida) I (Signature of Notary Public- State of Florida ) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR COUNTER REVIEW REVIEW DATE RECEIVED DATE COMPLETED Commission No. (Seal) PLANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW