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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: � Permit Number: `►�o.bN1CDG: - SEP 3 0 2021 0 St.Lucie County - - Building Permit Application 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 1' PERMIT APPLICATION FOR: P# ©'POSE�D IMPROVEMENT LO TKO Address: Property Tax ID#:� 7 Lot No. Site Plan Name: l Block No. Project Name: 1 I I DETAI ED DE,SC«RIPTION OF WORK.: New Electrical Meter Second Electrical Meter (Affidavit required) �ONSTRUC �N INFOR TION: Additional work to be performed under this permit—.check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters Window;s/Doors _Pond i Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: $ 1 Utilities: —Sewer _Septic B Iilding Height: CON T OWNER/LESSEE• RA pO 11 Name Name: !!� Address fi Company: Cit State: Addres Zip Code: Fax: City: State: Phone No. E- Zip Code: Fax: Mail: Phone No 771 Fill in fee simple Title Holder on next page(if different E-Mail l/ from the Owner listed above) State or County License Q 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. 1' S PPLEMfN L CONSTRatJCTla LIB LAW IN'FnRMNO"M DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: I FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: I 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, plerform 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 concurren�cy review: roo I 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 ble recorded in the public records of St. Lucie County and osted o he jobsite before the first inspection. If you intend to obtain financing, consult with lende atto before commencingwork or recordingour Notice of Commencement. Sign ure of Owner/Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF : k-3r Sworn to(or affirme_q and subscribed before me of Physical Presence or Online Notarization this'56 day of a Se 20a0 by Name of person making statement. I Personally Known OR Produced Identification T pe of Identification Produced (Signature of Nota .......... DEANNA GIVEN:28, Commission No. t�p�,p uio State idaTnn55�t1�}ion HH 0My Comm.Expires Jan025Bonded through National Nossn. I' REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEIA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED. Rev 5/20/21 ' I