HomeMy WebLinkAboutBuilding Permit Application f
All APPLICABLE INFO MUST BE COMP D FOR APPLICATION TO BE ACCEPTED s 2
Date: Permit Number: � �® �l✓�
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Building Permit Application mo��t. ;e- k� '
Planning and Development Services
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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: 7" ` LV k
PROPOSED IMPROVEMENT LOCATION:
.Address: - g (7-3 r�' Pc un-, e._I
Property Tax ID#: Lot No.
1
Site Plan Name: &_::�G < — a/rtl CSC'rOn l Block No.
Project-Name: CO WI P-\ _' l
DETAILED DESCRIPTION OF WORK:
New Electrical;IVlefer :Second Electrical Meter (Affidavit required)
CONSTR.UCTIQN INFORMATION°
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: So. Ft. of First Floor:
Cost of Construction:$ ` Utilities: _Sewer _Septic Building Height:
OWNEI//{ SSE CONTRACTOR: '
Name , cdW✓\ p Name:
Address: �/ C � ► mac' 2 Company:
City: I(Zlo State:��= Address:
Zip Code: 3_3?0� Fax: City: State:
Phone No. �S �S�f S Zip Code: Fax:
E-Mail: 6-,n Phone No
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$7,500 or more,a RECORDED Notice of Commencement is required.
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SUPLENfENTALC�NSTRt1CTi01U LfLN LAIN INFORiVIAT101V
<<,
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE H ER: Not Applicable BONDING COMP of Applicable
Name: zilA Name: (�
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as' dicated.
.f$��St. Lucie County makes no representation that is granting aermlt will au horize the permit ho der to build the subject st: c r
which is iri conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or proh
ly.ibit such
structure. Please consult with your Home Owners Association and review your,deed for any restrictions which may app
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 commencingwork or recordingour Notice of Commencement.
I
Em
Y"v�•. SUSAN L.CARON
Notary Public-State of f loridaSignature of wner/ a /Cor) ractor as A ent for 0•wner Commission#GG 943434g ted
My Comm.Expires Jan 29,2024
STATE OF FLORIDA throughNationalNotaryAssn.
COUNTY OF
Sworn to(or affirmed)and subscribed before me of ae Physical Presence t io �r
this'ai8 day of.:54,o(em , ice 202( by ,, VP�B,, HEATHER BURFORD
__° ;state of Florida-Notary Public
=` Commission # GG 183217 t'.
Name of person making statement. """" February o6, 2022
Personally Known ✓ OR Produced Identification
Type of Identification Produced
(Signature of Notary Public-State of Florida )
Commission No. (Seal)
REVIEW_ S FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
�ev20/21