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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U Date: �5 a'� Permit Number: 91ro fl t a 1 RECEIVED - Building Permit Application JUL 15 2021 Planning and Development Services St Lucis#Gounty Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: ` Stot5l-qVebsen cambinRl PROPO ED IM Y3aVEMf1qTT,OC,ATICIN: Address: Q 3 q.0 �;-- y - - - Property ID #: © o. �o Site Plan Name: I;UlnI Man : S✓O Block No. _ Project Name: DETAILED DESCRIPTION OF WORK: S New Electrical Meter V Second Electrical Meter CONSTRUCTION INFORMATION: k 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 v Roof Pitch Total Sq. Ft of Construction: ` 11 70 Sq.-Ft. of First Floor: . IDS Cost of Construction: O® c; Utilities: —Sewer . t/—Septic JI Building Height: OWNER/LESSEE: _ -,CONTRACTOR:.ff _,.. Name ;r1 L o- ec el' Address: 7 Pi a . S , 6 1, _S —r Name: 5 Company: 4 ; o c- City: Q ; rCr- ce State: fL Address: 7 ng Zip Code: '_� J Q j o Fax: City: R. 'P`„ 't-c State: FL, Phone No. '7`a- NGy-111-7 Zip Code: �CO',�_® Phone No '"a Fax: E-Mail: l ,-s e- L S-•) 0.^4 Fill in fee simple Title Holder on next page ( if different E-Mail State or County License F S S c j g` Z X .� from the Owner listed above) 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. .. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name:_ kSkr)Je_ 1hocy& Name: 54.Lucia bd Address: 702 S 6t� St _ k c E-�uw�a2�u f Address: S4, tAc; \-rc . City: 14, ; x r Ct State: F L City: R . p; er ce State: %C, Zip: 4ggq 4; Phone 7-72 q69_l6.g1 Zip: --<qJm Phone: 77;.- q/ _c —/I/7 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 your Notice of Commencement. � � c (�� 'Z Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA J 501, LiaW, STATE OF FLORIDA f 54 , Ly'�4_J_' COUNTY OF COUNTY OF Swor to (or affirmed) and subscribed before me of is Swo�a to (or affirmed) and subscribed before me of 1� Phyys�ical Presence or Online Notarization thi Yiay of�(�rt' 2024 by �Isical Pre ce or Online Notarization this `day of 2020 by �'J I�l%�0 l�l, cabvulf\ ame of person making statement. Name of person making statement. Personally Known 1/ OR Produced Identification Personally Known OR Produced Identification Type of Identification Type f Identification Pro uced Prod d (Signature of N otary bbj� to mbtgbfl�qState of Florida _ Donna Lea. Askman GG 174054 (Signature of No ary Pu c?o9fa yOf fT���lbiic State of Florida Donna Lea Askman M Com issi Ez fires 022 Commission No. �+` a T ` E Commission No. ��o MyPCe�9�2022 17aosa �ff Gi I'7y 06q GG r7 qeq REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.