HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLET�D FOR APPLICATION TO BE ACCEPTED -ON9
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Date: f''A7 • �.,_ Permit NumbeFa 16 v
SM I L U C 0E RECEIVED
l a a ° ° Building Permit Application AUG 3 0 2021
Planning and Development Services St. Lu 'e County
Building and Code Regulation Division Commercial Residential fitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 2� o)
6, -1zv,,
��s I�d •
P+7te-rce ��-
Property Tax ID #:
a� 3) 02. ' 414
- o oa s;t-
Lot No.
Site Plan Name:
Project Name:
Block No.
DETAILED DESCRIPTION OF WORK: I
e
k a.e
W k r0 a 0 cJ_5 t-0 t In.
s 1)112 act
Y 0--kA
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l � C e,
�.Z�l rSoo i5
1 irn v cc-t.-i-
rG-ILoE
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical
_ Electric
_ Gas Tank
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 5, 0-0
_ Gas Piping
— Sprinklers
_ Shutters
(Affidavit required)
— Windows/Doors _ Pond
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: 73 -Kjq
CONTRACTOR:
Name S(.'�mtS 8e/II0 ( 0w-o [ 3 ,LLam_
Name:
Address: I t � S k4 Q_ r 1%72rt_43 -���
Company:
City: V &;rB i fig State:''-
Address:
Zip Code: 3 Vq.(a'2 Fax:
City: State:
Phone No. '1 L 2-1 �R
Zip Code: Fax:
E-Mail: S, Ahd \DL_L3 aC`0
Phone No
Fill in fee simple Title Hold r on next page (if different
E-Mail
from the Owner listed above)
State or County License
if valug of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If valu@ 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:
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 lendemr an attornev before commencing work or recording your Notice of Commencement.
of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
SworAto (or affirm ) a d subscribed before me of Physical Presence or Online Notarization
this Q day of 20a ) by
Name of person making
Personally Known OR
Type of Identificoon Proucei
(Signature of Notary Public -
Commission No.
REVIEWS
FRO
COUNTER
DATE
RECEIVED
DATE
COMPLETED
State of
on Y
KAREN S. NIELSEN
State of Florida -Notary Public
Commission # GG 207484
J - unel 12, 2022
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW