HomeMy WebLinkAboutBuilding Permit Application Oct 11 2021 4:03pm . LOUIE'S AIR CONDITIONING 772-429-5267 p.1
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: / " 1 Permit Number:Ni
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>� c t� I I, n 4� Building Permit Application
Planning and Development Services
Building and Cade Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: ! 5. b0E.t%-,< bp—
Property �
Tax ID#: ` -64 3 n C (no 8 Lot No.
Site Plan Name: 11-n Imo} 11��E) Block No.
Project Name: l•,41+A b 1 0
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 _Windows/Doors _Pond
_ Electric Plumbing _Sprinklers `Generator —Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ S�( Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name ' l �'�'A ' i-D Name: ' IS 1 AkI I—
Address: 4 6 -If Company: b U I E 5
City: J E�tiSAE�J a CA71 State:-rL Address: lo'93/ 7Ve4J7fW
Zip Code: 3`-)q S-7 Fax: — City: 711 _5+ L,I)0 1 4'- State:-
2
Phone No. o ` 3t!n�i " 7y E- Zip Code: ,J i4,q sc2 Fax:
Mail: Phone No ?lc;t- S~ 7D-7Z
Fill in fee simple Title Holder on next page (if different E-Mail [ A is)r_ 5 ._ Atli,
from the Owner listed above) State or County License (�[-D,-_2 .?2 7/
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.
Oct 112021 4:03pm LOUIE'S AIR CONDITIONING 772-429-5267 p.2
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 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 5t.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 attorney before commencing work or recording our Notice of Commencement.
Signatu of 6wner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF L5t t_u Lt e
Sworn to(or affirmed) dub cribed before me of Physical Presence or Online Notarization
this %/day of ,20M by
LdUIE J bJttJd+
Name of person making statement. ��u►mri/
4�� C Denise Lopez
Personally Known OR Prod etl Identificat' _� OMMAH113794
Type of Identification Produced •feS:Ilia 26,2025
Notary
A�A6;�4)
(Signature of Notary
`Public- e�of Vida)
Commission No. T 11 7 /(Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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