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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ' d I Permit Number: ,_ RECEIVED � 'ram llo L��}1L�- •", OCT 2 5 ZOZ1 BuildingPit Application St.LucleCounty erm p p Permitting 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: - Lr Address: Property Tax ID (9' f)0- © 019- r' Lot No. Site Plan Name: Block No. Project Name: MWO rNM ,W—RE Mom OWN-11101,1" M � co W4 W 1, -- - New Electrical Meter Second Electrical Meter (Affidavit required) a 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; Cost of Construction: $ / Utilities: _Sewer _`Septic Building Height: ISO -tea ` +X .ca _ Name ������� �eliN�j�� Name: Address: 2)t7,5 � r0 V� _D P 1 y� r � Company: S�r9FL Fl- C010C" � Nr`I City: Stater Address: Zip Code: 3 47 Fax: City: Tom- /DrFr[E Stater/ Phone No. 77 Z Z Zip Code: 3��r r1 2- _ Fax: E-Mail: Phone No -J 7 Z Za( /4S5 Fill in fee simple Title Holder on next page (if different E-Mail 5 PC d �S3`w^ 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. 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 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 STATE OF FLORIDA COUNTY OF �. 4 I Sworn to_(Dr affir Pied nd subscribed before me of �hysical Presence or Online Notarization this day of 20C?J by :!A- im 11) �­,, •I �—e, Name of person making statement. / Personally Known OR P o ed Ident'ficatio V Type of Identification Produced OAA d 'hA�17<1 A (Signature of Notary Iyu is State o i a ) Commission No. (Seal) AUDREYB.HUMPHREY MY COMMISSION#GG 300817 EXPIRES:March 6,2023 [3onded Th.Notary Public Underwriters Kaw d. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5 2 21