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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ) � - �W f Permit Number: Q ' r, IJ. 1M. L `-I CllL "-' . RECEIVED Building Permit Application OCT 2 5 2021 Planning and Development Services St.Lucie County Perms n9 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: (IJ-Plou- tA4f/lor a)c f PROPOSED IMPROVEMENT LOCATION: Address: 14 ) NSI= [.,,o1nMtY- k ffik S+• 1L . 6�uckp 349 Property Tax I D#: f �_�7„ t�— © C ) 1 n O O• Co _ Lot No. Site Plan Name: Block No. 7 Project Name: DETAILED DESCRIPTION OF WORK: (t_1 tee� CAA ay- ytm L 1 i' yoi G L' r R1X'�P11 cp l' D�OOr New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Additional work to be performed under this permit—check all that apply: / _Mechanical _Gas Tank _Gas Piping _Shutters V Window Doors _Pond Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: $ �p Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: � CONTRACTOR: Name mcffw ca; 'iiz ,�, Name: Address: 14�) Nt-; Company: City: Poi- 5�+ • L'Uut pp" State:_ Address: Zip Code: 349 9)3 Fax: City: State: Phone No. (60� --Jq 2/2)7.b E- Zip Code: Fax: Mail: CqVt?, -" A i Wp Mtn • t. M Phone No 0 Fill in fee simple Title Holder on next page(if different E-Mail 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. 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: Ad d ress: 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 le der op,4h attorney before commencing work or recording our Notice of Commencement. Sig ature of Owner/Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF Sworn to(or affirmed and subscribed before me of Physical Presence or Online Notarization this day of 20�)by 1'1'l air o Name of person making statement. Personally Known OR Produ ed Identification Type of Identification Produced 11 (Signature of Notary u lic-State of Florida) rl4q. ,'.n,:?y<<, AUDREY B.HUMIPHREY Commission No. (Seal) = r�i Myco mISSION#GG3003i7 w: Fi=u 'r_ EXPIRES:March 6,2023 Bonded Thru Notary Public UndeimfiterS ,.' ` .t�ArSKS53:i1L 1x REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev 2 1