HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
v L `u) w L L' `� 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
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID i
Site Plan Name:
Project Name: ,MQ�C A
Lot No.
Block No.
DETAILED DE(�SCRIPTION/ OF WORK:
10 (� Yt i �A A lid r'\ n%/\ r CAD Ti 7 .► n . _ _
New Electrical Meter Second Electrical Meter
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
Cost of Construction: $ (PO
�Z�
Sq. Ft. f First Floor: _
Utilities: ewer _ Septic
OWNER/LESSEE:
NamerGY7.i/3�'��ijs��.���v- -
Address:
City:/� ��>�r �! State:
Zip Code:. V;'1af-1`f/ Fax:
Phone No.-
E-Mail: L Co►�1
Fill in fee simple Title Wider on next page ( if different
from the Owner listed above)
� rr
Building Height:^
CONTRACTOR:
Name: TbrA
---------------
Company:
Address: 1'1'j7 S • 101 YY1 S 0 VJ S
City: State:1LQ
Zip Code: 1,1 V _ Fax:
Phone No Li a a - a -4L4 L4
E-Mail nfDGAC► �?,lci1.rtt-SN2d Cc
State or County License C.Q,L1 ZS 3 L�
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:
DESIGN ER/ENGINEER• Not Applicable
Name:. V� UAPX. w �`
MORTGAGE COMPANY: Aot Applicable
Name:
Address:_ 1"1'1'1 S A0Lr'YISDY\
Address:
City: :;Q— e,1r State: (�
Zip: (2 Da, 1p Phone qD_? aR o? -'a`� —
City: State:
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 Home 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 attorney before commencing work or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner Signatuire bf Co r/License Holder
STATE OF FLORIDA /%� STATE OF FLORIDA
COUNTY OF l/ COUNTY OF
Sworn to (or affirmed) and subscribed be e me of Sworn to (or affirmed) and subscribed befo me of
Physical Presence olio Online Notarization Physical Presence or Online Notarization
this day of D LJ_01x , 202 by this —I day of 2024 by
e G o _7 M S awe,
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identi ation Personally Known_ OR Produced Ident-
Type of Identification Type of Identification
Produced F i Produ d
(Signature of Notary Public- of Florid (Signature of Notary Public- of orida ptp assidy Berger 1? ry )
Q OTARY PUBL C �A Cassicly Berger
° NOTARY PUB
Commission No. - �L) s°-STATE OF FL emission No- aJ�i 2q STATE OF FL OR
{ Comm# GG97 29
-Expires 3/26 024- -- - —__ d Comm# GG97
10 Expires 3/26
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
_ COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE -- -- ---- --
I
RECEIVED
DATE - -
COMPLETED
ev. S/Q/26-- -- - - -- __ _ — -- --- —