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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: "'21afs.. O RECEM=D I '` 1. Building Permit Application AUG o 5 2021 Planning and Development Services 5t.Lucie County Building and Code Regulation Division Commercial Residential""-6161i 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR: ,PROPOSED IMPROVEMENT LOCATION: H Address: 570 3 2 .C-k r Property Tax ID#: 3 Lo r q ���a Uopj Lot No. Site Plan Name: Block No. Project Name: / 4,J Cam^ DETAILED°DESCRIPTION OF=WORK: tic twll For,-.,,J g,,t a .2,2'X)-Z' g!- )W6 it � S`a.'n 4" twk ulfl. 12" X 12" Forms .20 F /!G,/�V;l( (ora. E►...1. Diu� ..l /?.�.� �l'tw-�S �--� �/�G�•c_ �lt�•• yooa . .! F h-e_�/ut-S New Elec rical 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: 15 © B Sq. Ft.of First Floor: Cost of Construction:$ 2 0 OW CPO Utilities: _Sewer _Septic Building Height: ,OWNER/LESS°EE .CONTRACTOR:` Name LCe Ijo••S So h Name: CF'o2%AL-t — Address: S9Q f� L4 i CK*E:V Company: '3T(- Co h Cr L'�,C. �f'y$ L t �- City: 9r? fk4-,- State:EC Address: 32-$o C,-u�•w--.� Cc,...c,.(, �v Zip Code: 3100 7.. Fax: City: (Q ✓q Luc State: F� Phone No. 772-$0 l " �b�`1$ Zip Code: 31117 Fax: E-Mail: Phone No ??2- Z!6- l3et &Fill in fee simple Title Holder on next page(if different E-Mail - 'TC a GrlcFd-, f� /�S lam/ 0,01 G° from the Owner listed above) State or County License 2,8 5'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. (Yoa (-`3 SUPPLEMENTAL CONSTRUCTfON LIEN LAIN 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 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 improveme is to your property. A Notice of Commencement must be recorded in the public records of St. Lucie Cou y and ted on the jobsite before the first inspection. If you intend to obtain financing, consult with len r or Ka orne before commencing work or recording our Notice of Commencement. Signat a ner/Lessee/Contractor as Agent for Owner - ST E OF FLORIDA C UNTY OF S�" L_.tl" Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization this�day of .r .20' [by 0_ 'A" Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced_b/� (Signature of Notary Public-State Florida) Commission No. (Seal) ;1,`nYPVe� HEATHER BURFORD r° `; State of Florida-Notary Public •; Commission #GG 183217 ► Y Commission Expires February 06, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5/20/21