HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ' O
Permit Number:
RECEIVED
a Building Permit Application OCT 11 2021
Planning and Development Services St. Lucie County
Building and Code Regulation Division Commercial Residential Permitting
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: `e3$150 5,40CEANA D2. # 9yot
Property Tax ID #: 3535- 600 - 00A - -3 Lot No.
Site Plan Name: JZL.A tJD Dur.3ES CCL,*,j5►TjF- UpIT 9olc)- Block No.
Project Name: 501 fJ E)Dw- i2E51D&Jcf
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New Electrical Meter Second Electrical Meter (Affidavit required) S,aaw�e 7►z„+�+s,
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Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Pond
_ Electric V plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ g mcic1 �Utilities: —Sewer _Septic Building Height:
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Name �E8AIE- I.l,.3�,01se
Name:'-,012 15 RoGE2S
Address: _ ZS$$0 5, OC I�A^J DP-. -4 G?da"
Company:-,.._STprL- PLUn^31,-Jr SEC vrcEs. I AJG
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Zip Code: ZNciv Fax:
Phone No.,h I]) G,a-I -530LO E-
Zip Code: Fax:
Mail 1DSJSc545 Q 661-.Cann
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Fill in fee simple Title Holder on next page (if different
E-Mail 171con)
State or County License 199846a
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.
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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 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 attorneybefore commencing" work or recording our Notice of Commencement.
Signature of Owner/ Le a/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF �
Sworn to (or affirm d) nd subscribed before me of Physical Presence or Online Notarization
this J day of ✓ 2021 by
Name of person making stat ment.
Personally Known � OR Produced Identification
Type of Identification Produced
(Signature of Notary Public- State of Florida)
State of Florida
Commission No. (Seal) VALHO
Rig
n GG 950192
12024
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETE D
Rev 5/20/21