HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �� �`
Date: Permit Number: � Vl� '� C.�;)
91ro ILUCDIE 11 RECEIVED
° JUN 0 8 2021
Q .ar s6°°L` Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT.APPLICATION FOR: Shed
P;.ROPOSED4IVIPROVEMENT LOCATION'
at, Luale CDU*
Permllufla
Residential .X
Address: 7405 PENNY'LANE
Property Tax ID #: I SO L C a Q 1 ' Q D,9 -7. 000. Lot No. 18 & 19
Site Plan Name: LAKEWOOD PARK UNIT 7 Block No. 81
Project Name:
New Electrical Meter Second Electrical Meter
CON�SI'RUCTION IryNFOTRNIATION
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: Sq. Ft. of First Floor: _
Coo ofCon"str, mon. oc) Utilities: _Sewer _Septic
Building Height:
OWNER/LESSEE`CONTRACTOR
Name LAURA DOMINGUEZ
Name:
Company:
Address: 7405 PENNY LN
City: FORT PIERCE State: FL
Address:
Zip Code: 34951 Fax:
City: State:
Phone No. 561-676-7877
Zip Code: Fax:
E-Mail: LNJ9603@GMAIL.COM
Phone No
E-Mail
Fill in fee simple Title Holder on next page ( if different
State or County License
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.
11
SURP.LEIVI,ENpTAL CONSTRUCTfON,LIEN LAW INFORMATIONz ,r.. '.
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
_ Not Applicable
State:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
_ Not Applicable
BONDING COMPANY:
Name:
Not Applicable
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 attornev before commencing work or recording your Notice of Commencement.
U. - , OL;L
—
sSi', twn°e'P essee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF c'}— JVL.lL
COUNTY OF
Sworn (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
this day of .5, QV-C— 2021 by
this _ day of 2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced e
Produced
� ``�' NOl ��i
a$ �9��
(Signature of Notary Public- Sta of Florid =�
(Signature of Notary Public- State of Florida )
`n
Commission No. Se
( � d Z
Commission No. (Seal)
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REVIEWS
FRONT
ZONING
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
:E G
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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ev. 5/6/20