HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
L-U�U� RECEIVED
k'.. SEP 2 0 2021
il, `'- > c r� �`=-= Building Permit Application
Planning and Development Services St,P Uf1<y
Pot ft
Building and Code Regulation Division Commercial Residential 9
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION: -j
.w
Address: ���7'3 �' a�� t , \ t1�c J
Property Tax ID#: ���I — 0 7-- C�Cw r—C.�C�C�—� Lot No. �Cl—1 -;',
Site Plan Name: Block No. 1z
Project Name: 1� 'C�•t_L ti�irc � \1vC� �� -- -_
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Window oors Pond i
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Z) Sq. Ft. of First Floor: t
Cost of Construction: $ X-2 , OHO - Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACT OR:
Name \ Name: _
Address:
'� 3 �C�y�r�.� Company: _
K
City: Stater Address: do- I
Zip Code: Fax: _ City: State:
i
Phone No. _E- Zip Coder Fax: I�
Mail: Phone No -1-17—^ -64tCK 27735�
Fill in fee simple Title Holder on next page (if different E-Mail
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 regc'red.
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 U'NIPANY: _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. n:..
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 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 mu A 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.
Signature o ner essee ontrac0 as Agent for Owner
STATE OF FLORIDA
COUNTY OF
Sworn to(or affirmed)an subscribed bef re me of P" hysical presence or Online Notarization
this ?day of 20 by tt
I }_
Name of person making statement.
Personally Known _OR Produced Identification '-
Type of Identification Produced
(Signature of Notary Public-St e of Florida)
HEATH7ERRD
,,Commission No. (Seal) _� `�-State of FlPublic
Commiss3217MY Comires
Febru2
REVIEWS FRONT ZONING SUPERVISOR PLANS [�REVIEW
EGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
DATE --
RECEIVED
DATE
COMPLETED c
Rev 5/20/21
` r
a,
MICHELLE R. MILLER, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY +
FILE # 4924646 OR BOOK 4686 PAGE 5 , Recorded 09/17/2021 11 : 17 :05 AM
NOTICE OF COMMENCEMENT 4?
Permit No. Tax Folio No. L'ZatT>l "' L—o-7 &,�kLe
State of Florida County of St.Lude
i
The undersigned hereby gives notice that improvement will be made to certain real property,and in accordance with Chapter 713,Florida Statue•.
the following information is provided in this Notice of Commencement. �
Le at Description of property:(and street address if avaiia le): C
�-t� 7�`�a�•r
General description of improvement:
Owner info r�na_tion or Lessee Information if the Lessee contracted for the improvement: e3.
Name
Address
Interest in property: t,t,f.1•C � ,
Name and address of fee simple titleholder(if different from Owner listed above)-
Contractor Address: ! Phone Number.
Sure Cif a ticable,a ce o
Surety r pP pY the,pa meet bond- ached):Amount of bond:$ + t
Name and address: tI I T Phone'number. 11
I /
Lender Name: f c ,'/T Phone Number:
Lender's address: T
+
Persons within the State of Florida designated by Owner upon whom notices or other docur..ents may be served as provided by Section
713.13(1)(a)7.,Florida Statutes: `
Name: Phone Number,, i
Address:
In addition to himself or herself,Owner designates / of to receive a copy of the
L"tenor's Notice as provided in Section 713.13(1)(b),Florida Statut . {
Phone number of person or entity designated by owner titi.
Expiration date of notice of commencement~ (tf7e expiration date may not be before the completion of construction and final payment to the ,
contractor,but will be I year from the date of retarding unless a different date is s)ecified)
WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,SECTION 713.13,FLORIDA STATUTES,AND CAN RESULT iN YOUR PAYING TWICE FOR '
iMPROVEMENTSTO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE allORE THE FIRST
INSPECTION.IFYOU INTENDTO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR rk
RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalty of pedury,I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the bPtif i
` my kuowledge and bel}ef.
4�- 'n ;+
Signature f Owner or Lessee,or Owner's or Lessee's Autho zed Officer/Derector/Partner/;tanager
� �yn�,�
L.iJ'rt�10'7, It r
(5lgnatory`s Ti WOffice)
STATE OF FLORIDA
COUNTY OF =n rl I21�C r
The foregoing instrument was acknowledge before me by means of d physical presence or D online notarization this , day of
20 ai by�I 1�C.1 D C E t 1 Dr�•r 1 Alt wlnia is personalty known to me or has produced h �. ,) as identificatio,
,xY,J MEUSSADENNISTCN
Notary PubVic-state of Fonda -
(NOTARIAL SEAL] GG 339670 _
My Com r.Ezpire Sep?<.2 RY PUBLIC,Stat of Florida