HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST awry vlo ION TO BE ACCEPTED _ ��
Date. Permit Number:
SEP 0 8 92021
c Lo`L�L!C � RECEIVED
Lucie County;,Permitting
' -- Building Permit Application SEP 0 8 2021
Planning and Development Services St.Lucie C my
Per ing
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:
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Address: l -�1 `� l N W OO D 4F , rbar ?�eacE� z,rG 30/98 L
Property Tax ID#: Z ��2�' 601 - 0/0% 060- 7 Lot No. /ro
Site Plan Name: Block No.
Project Name:
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AI�ED DCRIPT(QItI 1= IORIf, }
(2�- Roof--lu Ie w eA SHi I yeU A
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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: (, VP g Sq. Ft.of First Floor:
Cost of Construction:$ /0/SOd Utilities: —Sewer _Septic Building Height: !2 ► —
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Name 7/ LI N GvpBO L e Name: L 0 il)goo
Address: ,nS 0�0 �� YiE J-}ioy�vu0i�1 101 Company: osM' 6&/�e t/ otiaWl-ridV d p0.
City: V b �✓ State: Address: 718S t n aG �'<F
Zip Code: Fax: City: 4'+KE Iveem State:�L
Phone No. 6b- 53l- 0`l7 E- Zip Code: 33 /b Fax:
Mail: COr+ri*a'rrrnfYO @� YYth"I.lto w Phone No Ol- yW/' 93
Fill in fee simple Title Holder on next page(if different E-Mail L JCS. zd o JV 1 r--4 • el
from the Owner listed above) State or County License 133
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.
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DESIGNER/ENGINEER, _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE OLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: 4 Name: Wlk
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-OWNER:Your failure to Record a Notice of Commencement may result in paying twice for
improvements to our property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and sted on the jobsite before the first inspection. If you intend to obtain financing,consult
with lender o an torne before commencing work or recording our Notice of Commencement.
Signature of Owner/Le see/Contractor as Agent for Owner
STATE OF COUNTY OFORIDA����
sworn to(or aff' ed) d subscribed before me of Physical Presence or Online Notarization
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AWA �WIO
Name 8ri5erson maki7k tement.
Personally Known OR Produced Identification
Type of Identi i ation Produced
(SignatuM of Mary P I
ic-State of Florida)
Notary PubNc,State of Florida
Commission No. (Seal) a
Juan I Gonzalez
My CwwdssW GG 980739 Expires 04/26/2024
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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