HomeMy WebLinkAboutBuilding Permit Application 10.27.21All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I c (�Z- I Permit Number:
U L U
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
CBDG Funding_
Residential
PERMIT APPLICATION FOR: i RC3c+-
PROPOSED IMPROVEMENT LOCATION:
Address: 5� T -1
Property Tax ID #: �13C)- - — T
Site Plan Name: I Lot No.
—� Block No.
Project Name: �, (Sirnm
DETAILED DESCRIPTION OF WORK.
�11 811
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to he performed under this permit- check all that apply:
—Mechanical — Gas Tank Gas Piping — Shutters Windows/Doors _ Pond
— Electric — Plumbing — Sprinklers Generator J Roof p• h
Total Sq. Ft of Construction: _d(9 5 8,
Cost of Construction: $ — 9> um
OWNER/LESSEE:
Name l Unn tp
Addrree ..�: �� % 4 G U-A
City: F State+
Zip Coder Fax:
Phone No.
itc
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
Mail:
Fill in fee simple Title Fielder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name: Y
Company: 1 5
Address: P 1 ni
City: J I(JjL`.. C� Stater
E- Zip Code: 1 Fax:
Phone No 3 F -7
E-Mail
State or County License"'Iti3�-1i(pr j
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
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
city:
City:
Zip: Phone:
OWNER/ rnNTRArTnO ACr1n►JJ'r �__
Zip: Phone:
-- - ... � —1 ^� - y � 1 • APPHLjumi h, hereby mace 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 wfth 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 fender or an attorney before commencing work or recording our Notice of Commencement.
Lodes I/1/ r
Signature of Owner/ Lessee/Contractor s Agent for Owner
STATE OF FLORID
COUNTY OF.1 n
Swo�Mo (or affir d).and subscobed before me of Physical Presence or Online Notarization
this+►►_ day of 20Q�_ by
Name of person making statement.
Personally Known OR Produc Identification
Type of Identificati
(signat e 6T Notary Public- State of Florida)
Commission No. (seal)
CONNOR FOLEY
r° =' Notary Pubic -State of Florida
Commission # GG 329803
';raf�toP° MY Commission Expires
May 01, 2023
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED