HomeMy WebLinkAboutBuilding Permit Application Al
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ��' 3 -a, Permit Number: -o \1\- d o16
RECEIVED
Building Permit Application � Nov 0 3 2021
L3I-I-uQla County
Planning and Development Services P@FMitil
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:
PIS POSED IIVIPROVEMENT��LOQCATIQnN nAv
Y
Address: 770a (�Jr,, nti.C/ccA R Pam.
Property Tax ID#: 4tJ42.2- 81J'000 S- b 00 Lot No.
Site Plan Name: �7 ar►�eo-( by�}�uw�can Block No.
Project Name: .
DETAILED DESCRIPTION=.OF WORK;
New Electrical Meter Second Electrical Meter
CONSTRUCTIrt7N,INFORIVIATI'ON
g
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 9 L Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ /99,06o,o), Utilities: —Sewer _Septic Building Height: 26"
OWNER/LESSEE CONTRACTOR:
Name Name: BA44 S.14 g...
Address:_ 53/ 7 /4 4(Uw,% E(wy Company:
City: 7vYu•,, State: ON Address: /I I St Alg42Lw� aL.-
ZipCode: Caw„(,&, Fax: M?A-awl City: &4.rf,Cc�e"- 0 State: FL.
Phone No. Zip Code: 31f 9.f L Fax:
E-Mail: Phone No 777- 33s-9J3'O
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License_ CCC03Zs'13
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,500 or more,ra RECORDED Notice of Commencement is required.
S:UflPPLEMENTAL�CONSTRUCTION LIEN�LAW IN'iFO-RMATION `.
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 consullt 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
wi nder or an attorney before commencing work or recording our Notice of Commencement.
igna of Owner/Less e e/Co—nlTacto V as A nt r Owner
STATE OF FLORIML
.
COUNTY OF
Sworn to(or affirmed)and subsc ibed before me of Zphysical Presence or Online Notarization
this/') day of 20 2/by
Name of person makiAd statement.
Personally Known v OR Produced Identification
Typ of Identificaition Produc
(Signature of Notary Public-State of FI
JENNIFER DAVIS
Commission No. (Seal :w; *. MY COMMISSION#GG 953418
"; Po EXPIRES:February 29,2024
eOa,P° Bonded Thru Notary Public Underwriters
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5/20/21