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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: i� ' �oZ'�-� Permit Number: to -\w RECEIVED O p " Building Permit Application AUG 12 2021 g pp Pt, PUMP Qm4nty Planning and Development Services PaF�ltllnp Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: PRO POSED, IMPROVEMENT LOCATION. ' Address: / r-Oa �/ t�/ sL,i 7,F,.c9 G.�r�1CG.� ,�'!'%_Za2 &r-z5z zq- 3G1gG' Property Tax ID#: gg2G,--Pas-agZz-at,?a-6 Lot No. Site Plan Name:Block No. Project Name: S'G✓��13�5� Ci�LG,B(,° DETAILED DESCRIPTION OF WORK: . i4.�i✓aU�f� ..�i�®.��6�► ��T/}ilO®�-c' d/�.Z'�G��i� /,vs7/�' ����Ti�-TG.oL New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additional work to be performed under this permit- check all that apply: (Affidavit required) _Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond X Electric ,X Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: z / 7,? Sq. Ft. of First Floor: Cost of Construction: $ S3eda Do Utilities: ,]Sewer —Septic Building Height: 4 OWN ER/LESStE: CONTRACTOR: Name <Zz-,✓GI ?O,✓ Name:^/10.✓ _S/.��/� Address: Company: CG,✓_s'oL���vG� ,AGOG TAP City: oeferzig e - Y State: ,o:f� Address: 7�D1S�✓ �L`.��' Ale b/ ,Y // Zip Code: 3Y99© Fax: City: _S22�,2T State:�y Phone No.ZD - 6"%a Zip Code: _-2,3 y9 7 Fax: E-Mail: Phone No �7 Z-j-= ram' D 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 required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: ! O�o�iya-,fSn,9a�i✓ Address: y/7 efdA;E�T ,,a44a wo Name: Address: City: —g� A /7 v— State: �z City: State: Zip: Y y 9 9G 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 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 Nome 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 vour Notice of Commencement. Signature of Owner/ essee/Contractor as Agent for Owner STATE OF FLORIDA LyGt COUNTY OF. Sworn to (or affirme ) and subscribed before me of Physical Presence or Online Notarization this 01 day of 20,&1 by Name of person making st ment. Personally Known � OR Produced Identification Typ tification Produced O (Signature bf Notary Public- State of Florida ) Commission No. y' 29907 (Seal) ,fr' Notary Public State of Florida g Robin Sullivan My Commission GG 929907 y Expires 11/06/2023 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev5/20/21