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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED a Date: Permit Number:" RECEIVED SEP 14 2021 Building Permit Application St.Lucie County Permitting 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: PROP©SED IMPRC►VEMENT LOCAT)tN ._. Address: a C I do� Property Tax ID#: d � Lot-No. / P Y z Site Plan Name: Block No. Project Name: DETAILED DESCRIPTIOi�I OF 1NORK C 4� p, f / New Electrical Meter Second Electrical Meter (Affidavit required) F'2��YUi On g VLSI SA CaNSTRUCTIQV INFORMATION• r (J h 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: Coo Sq. Ft. of First Floor: . Cost of Construction:$ f 5,-0 ©Q Utilities: —Sewer —septic'- Building Height: C►WNER/LESSEE CQNTRACTQR .., . _ Name c,uo. O, Name: rv." Address:\05_( i2 U Company: ri City: C4 State: Z Address: 54) vi li _ Zip Code: _ _ Fax: City: �•L� 5`'7" ��� State: t5 Phone No. SG 5 Zip Code: �� Fax: E-Mail: Aa&_.qy 616 -n ma`• _ Phone No 50 5� Fill in fee simple Title Holder on next page (if different E-Mail avi u " 9 2- from the Owner listed above) State or County Licensees 1z 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. SUPPLENIENTAl:.CONSTRtJGTf(7N LfEN,LAW IfVFCtRMATION ,.� a . '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 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 our Notice of Commencement. / (-) .,D VZP Sigr4ture of Owner/Lessee Contractor as Agent for Owner STATE OF FLORIDAA. ` COUNTY OF Sworn t (or affir d) and subscribed before me of Physical Presence or Online Notarization this day of 2<� by Name of person making statement. Personally Known o uced Id tificatio / Type of Identification Prod ed (Signs re of Notary blic-State o F orida) •!Y`ft;•. AUDREYB.HUMPHREY Commission No. 6 (Seal) i i11,` :,., MY COMMISSION GG 300817 ,. .•:c'�;.ro: EXPIRES:March 6,2023 +i Bonded Thru Notary Public Underwriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5/20/21