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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1411 Permit Number: I �;Uol115 I. RECEIVED O - ° - Building Permit Application SEP 3 0 2021 Planning and Development Services St'Lucie Lucie Cou ty ' Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding I l PERMIT APPLICATION FOR: �� I PR9,O @D 11 RNA EMEN LOCATIRMS Address: Property Tax ID#: '��� " Lot No. Site Plan Name: Block No. Project Name: � I DETAILED DESCRIPTI©N OF WORK: 04 New Electrical Meter Second Electrical Meter (Affidavit required) CONSTR�U'CTION I'NF©R�MATI N' 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 g Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: 1 Cost of Construction: $1 50,dd Utilities: _Sewer _Septic Building Height: i UVV E: CONTRACT}+R: Named Name: r Addres Company: Name ',y: t �/t/�.e State: Address` �3 W /� Zip Code: 117 7Z Fax: City: 1 I State: Phone No. E- Zip Code: 44 Fax: Mail: Phone No 77Z ZgSITZ& Fill in fee simple Title Holder on next page(if different E-Mai Ice GL, from the Owner listed above) State or County License 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. i I I I' S 'PPINIEN At CONST +UCTIaN -N !A -Ill It!III III III III III 111 111111 1 1111M DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: i _Not Applicable Name: Name: Address: Address: City: State: City: ' State: Zip: Phone Zip: Phone: 1 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 conflicts with any applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Homeowners 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 anotherinon-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 ini 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 an att nev before commencing work or recording our, Notice of Commencement. 1 1 Signature of 0 er/ essee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF 5A- Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization this%0 day of 20 by � �r� a ,rn iv\g Y\ { Name of person making statement. Personally Known OR Produc Identification Type of Identification Produced a (Signature of Nota ublic Il orida) DEANNA ` f Florida c�v Pu�r;. Notary Public State o �Fd.k�o Commission=HN p86359 Commission No. ) Ex Tres Jan 28,2025 rg My Comm. P Natiorai Notary Assn 5ondedthrough REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW 0 DATE RECEIVED DATE COMPLETED Rev !1 1