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HomeMy WebLinkAboutBuilding permit appI SUPPLEMENTAL CONSTRUCTION LIEN LAW 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 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 C9,unty and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lofichm orA6-2torney before commencing work or recording; vour Notice of Commencement. &9'� _J Signature o rwner see/Contractor as Agent for Owner STATE OF FLORIDA �.r 1-JGiC COUNTY OF Sworn to (or affirmed) and subscribed before me of X Physical Presence or Online Notarization this K�3 day of CX M be M 20,21 by ye0rLC-,G Role ova Name of person making statement. Personally Known _ OR Produced Identification Type of Identification Produced 'I"rk?, _ (Signature of Notak Public- State of Florida) Commission No. 3� fo (Seal) ... y i . YADYRA MARTINET GONZALEZ / 5 Notary Pnbtic • Florida Commission �A? r HH )7410 µy Comm. Expires Aug 30, 2024 Bonded through National Notary Assr. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: � Luc- ut Building Permit Application 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 CBDG Funding PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: ,ddress- 9n< V-% -A'1 1v-1 C'+ en r 1�.o0 C o L Property Tax ID g: ;W - Cap — p -- Lot No. Site Plan Name: Block No. Project Name: ! DETAILED DESCRIPTION OF WORK: New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additional work to be performed under this permit -check all that apply: —Mechanical — Gas Tank _ Gas Piping — Shutters (Affidavit required) - Electric _ Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: Sq. Ft. of First Floor: Windows/Doors _ Pond Roof Pitch Cost of Construction: $ 1 O©c�:) Utilities: —Sewer _Septic Building Height: OWNERAESSEE: CONTRACTOR: Name o K2-(2-- Name: Address: *kOS Company: �moo-cL kLLM k'r:rru Address: 2125 ye rzg ci& f�•a� City: szgzr Q, erLr--% _ State: I- Zip Code: Fax: Phone No. E- City: EnX -sT a -6-IL State: Zip Code: 2)14 9 S 3 Fax: Phone No 1 iA Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail 'i cr�neciti�a r� e_lec_TRs� 11�„,r�t,.Q State or County LicenseC--(-- i2p<!>gc33(A 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.