HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I1 3- Z 1 Permit Number:
r` L` Building Permit Application
Planning and Development Services V
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 349S2
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 4 1,4ke _VlA rail c2o.) Pbr-fSf Lucie
Property Tax ID #: 3 qa-R - ,56o. 6-2 Y 7. 000- 3 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
3rZ) 441lop eke g t r l c w a- e r
Li ke-71 for li#e
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
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 _
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 6 00 d Utilities: —Sewer _Septic
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name l!eeNf For-te- 77—
Address: cl'�-Rl f5- S Or
Name: arV W analb
Company: art S Luti e N
Address: -LUZ Neritwer
City: Fort a Le -le- State: Fl-
Zip Code:305-;- Fax:
City: ne-SCOIZS4f State:
Zip Code: //74�v 7 Fax:
Phone No. E-
Mail:
Phone No 77,71- g6z-(a5c q
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail rf 5�t IU,Cie D
l uM f (E3� C�lfGel �• C'.0 ,
State or County License I
C FC o Se b ,� 15
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.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIG
Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
BONDING COMPANY: Not Applicable
Name. _
Address:
City: _
Zip:
Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permitto 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 consultwrth 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 attorne before commencing work or recording our Notice of Commencement.
Signat r. f er/ Les a/Contractor as Agent for Owner
STATE OF FLORIDA �
LRCI e,
COUNTY OF '5tQ
Sworn to (or affirmed) ands bscribed before me of Physical Presence or Online Notarization
this day ofQ i/ 2021 by
ry k/ Zany df ( dd
Name of ptrson making statement_
/
Personally Known OR Produced Identification
Type of Identification Produced
Jdwz�m '&�
(Signature of Notary P ac- State of Florida) (�Liia"Ww Dow
Y R r 4
s �lI1111.GGV5V
Commission No.{S�l /f �� r
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(Seal) Ei,,�• ��+�•
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Bonded TW Am ftry
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5/ZU/21