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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED' Date: Permit Number: RECEIVED g' (D Building Permit Application OCT Y 1 2021 Planning and Development Services t. 6u®i ,Eounty Building and Code Regulation Division Commercial Residentialpor On 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding PERMIT APPLICATION FOR: PROPOSED IMPROI/EMENT LOCATION: Address: 01 \ �f Fra".peaty Tax -ID #` .� • /� ' f/(Jl o�L Lot No. 49 9 Site Plan Name: Block No. Project Name: DETAILED DECRIPTI©N OF WORK: r J r New Electrical Meter Second Electrical Meter (Affidavit required) ode' CONSTRUCTION INFORMATION: f3 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: Sq. Ft. of First Floor: ff //// Cost of Constructin: $ �r 22 &oey Utilities: _ Sewer —Septic Building Height: OWINS ER%1K9 R@E WO NS ITI ©R: Name: A%1 - 'Tame` L Company: _WUid Iq R"LSE F / Address:(°}111 City}-. e�� _ State:T--i Zip Code: ��Q �S Fax: Add rep%%�� .3�%3 S 1J. Al d 4 � r i c% 5'T City: i'C? S1_. r State: Phone No. %r/a?- '70 E- Zip Code: a2l9_6.3 Fax: /^a�4 Mail: P19_ I12c3LLx5N41 Phone No 7%e-'5 _F_il-Lin fee simple Title Holder on next page (if different E-Mail _ State or County License Sfi. L,c;G r 1,14.7.8 / A89 from the Owner listed above) 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. l� SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not.Applicable Name: BONDING COMPANY: Not Applicable 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 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 corumonciAg work or recording your Notice of Commencement. cr---mil u Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLO A Liu► COUNTY OF . c—L'Q Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization this _%__ day of CZ_-)r0b2r 20.1L by Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced (Signs of Notary Public- State of rida) YVETTE ELIZABETH PEPPARD `` \` Commission No.1A (Seal) .; .- MY COMMISSION #HH000307 EXPIRES: August 8, 2024 '"Z. P d "' Bonded Thru Notary Publk Undeiwiit" REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5/20/21