HomeMy WebLinkAboutautoverification10052021All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: (o " OS ' � 1 Permit Number:
a Building Permit Application
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
PERMIT APPLICATION FOR:
Address: 2An: ,S`CI,I(1�-1-t-c e-�3"b Lo �° �i9
Property Tax ID #: 14:53 "_ �;D4 - cie[ci- 000-I Lot No.12419
Site Plan Name: UANIS O VYi rn t) 0-1'tc.,L cc `Qf Block No.
Project Name:
Ot NL aA's. u b i 5 VA;
New Electrical Meter Second Electrical Meter
(Affidavit required)
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: �� Z Sq. Ft. of First Floor:
Cost of Construction: Utilities: —Sewer _Septic Building Height:
Name 'Vt4fi Gl)1- (Vl + t 4 rG4JNfi
Address: U22 S S 04vli- LKCI L-?)M t-)42gi
City: D Q jY,A(C:r" State: ��-
Zip Code: `� Fax:
Phone No. 4-o-1 - 10-'' (a 11 4 E-
Mail: 065)3 0camet, _Cv,
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: ,ism i6rowrl n�
Company: &-C. -i- (e- t
Addres 9 ® &A I
City: State: , I State:
Zip Code: Fax:
Phone NoJr—
E-MailTbrown.rnt GtC A1�.0 ire
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 required.
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: — Not Applicable
Name: Nam
Address: Address.
City: State: City: State:
Zip: one Zip: Phone:
FEE SIMPLE TITLE HOLD _ Not Applicable BONDING COMPA 1 • 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 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 NER: Your failure to Record a Notice of Commencement may result in paying twice for
improve is to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie C y and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with I r or an attorney before commencing work or recording our Notice of Commencement.
ev
i ture o Owner/ Lessee Contractor as Agent for Owner
STATE OF