HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:-.,,?l/
. RECEIVED
Llls h b_; 14 2021
BuildingPermit Application s t
St,,
Lucie County
Planning and Development Services / permitting
Building and Code Regulation Division Commercial ✓ Residential
23UU Virginia Avenue, Fort Pierce FL 34-982
Phone: (772)462-1553 Fax: (772)462-1578 C13DG Funding
PERMIT APPLICATION FOR:
PROPOSED IM'_P ROVE ME;NT LOCATION:
-
Address: V bp 1 Ar 9iMct iS L - 21 v�
Property Tax ID#: 5 L I q - 5 1 S 00 0 2. - 610 -3 Lot No.
Site Plan Name: n Block No.
Project Name: Lar�;�_l glt oo/�I����cr.�r��, t ^ �u s�' Sid G
DETAILED DESCRIPTION OF WORK:
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S crGw� dow ll Vt W t2 I ,� l f ✓�S}��1 2 n 1,{ cJ Isle 0 / '� 9'" 1 l t,11 a off
!/l.i�„�� D�L ��V G Pl'-1-a.ot n �C eC� �10�r/'� �JY'�l.s t.��I ✓✓l�(D
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION: . l
Additional work to be performed under this permit-check all that apply:
—Mechanical —Gas Tank —Gas Piping —Shutters —Windows/Doors —Pond
l
Glertrir Dhirnkina Cnrinklarc r nnorntnr Rnnf I y 2 Ditrh
Total Sq. Ft of Construction: / q u 0 Sq. Ft. of First Floor: /
Cost of Construction: $ 20, 000 Utilities: —Sewer —Septic Building Height: /D 7-
OWNER/LESSEE
CONTRACTOR:
Name /- c Name: /A ilk l R&4 4e1i c.
Address: 35 41 SW Vi l Le %e% S-� Company: StiaCr 10/ �uo Fi,,,, 9 �eAalr Scrvlcef LLc
City: Por� S-- f-"e State:12- Address:JDg I _C W T�utz:ss�A c A�e
Zip Code: 34`( 3 Fax: City: ,air L S-I- L kud r_ State:��-
Phone No. S 6 I--212-• LI S t{ E- Zip Code: 3H01.(3 i Fax:
Mail: Phone No 63t1 - 6 f
i
Fill in fee simple Title Holder on next page (if different E-Mail M1144 l! fb V"'/ • Gvi+'J
from the Owner listed above) State or County License GG(Z 3 3 'z 2 7A
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.
SUP,PLEMENTAL.CONSTRUCTION LIEN.LAW INFORMATION::
DESIGNER/ENGINEER: . _Not Applicable MORTGAGE COMPANY: _Not Applicable
Ninn•trn• mama-
Address: Address:
City: State: City: State:
Zip: Phone Zip: _ Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
AdA�-Yno• (�I4m�•
dress: 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.
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St. Lucie County makes ho 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 Toiiowing building permit applications are exempt from undergoing a TO concurrency review: room additions,
accessory structures,swimming pools,.fences,walls,signs,screen rooms and accessary 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 attorney before commencing work or recording our Notice of Commencement.
Si ature of Owner/Lesiee/Contractor as Agent for Owner
STATE OF
r.ni.]NTV OF IST 'Je
Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization
this,1[day of to 20U by
Name of person making statement.
Personally Known OR Prod ed Identification ✓
Type of Identification Produced 't I y�N -
(Signature of Not a
JOSE RENTERIA
Commission No. My CI¢ );ION#GG207306
EXPIR
Bonded Thru NOWY public U 022
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION 1SItAIUKILL MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW I REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev 5/2u/11
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