HomeMy WebLinkAboutBuilding Permit Package AMIL
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION.TO BE ACCEPTE
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'Date: Permit Number: Q�u
9 lla F—L u,Cflrvm% RECEIVED
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Building Permit Application Nov 0'9 2021
Planning and Development Services Per itting Department
Building and Code Regulation Division Commercial Residential It.Lucie county
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
Address: !�5 Y4P_,,,IA eP_ 6Ae genic 9r zf5
Property Tax ID#: '- Lot No.
Site Plan Name: 1r.Qi Oq f Block No.
Project Name: '
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WHEN
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New ElectricarMeter: '.. Second.Electrical!Meter (Affidavitrequired)
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: Sq. Ft. of First Floor:
Cost of Construction:$ �fv ��� Utilities: _Sewer —Se p-tic Building Height:
_--w ` '.`r'SM" -{' ""y, �: 'y _ .E•+9._ ,zee
1001
Name )��'"f? Nam'e:. nftfl P t �L
Address: i'j ' .,, �c.:.. .,.': Company: CbydG �
City: ,.State;
Zip Code: _ ;� is Fax:� City: 10D2% >-7� La c:.j'E State:
Phone No Zip Code: 3Y0153 Fax:
E-Mail hb ,4U) �( � '� '� Phone No 7;W — '3 3h W6
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Fill in fee simple Title Holder on next page ( if different E-Mail n _
from the Owner listed above) State or County License �_'J cl g CID-
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 .
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City:. State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _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 is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners 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 attorney before commencing work or recording our Notice of Commencement.
A
YVETTE ELIZABETH D0003O7
Signature of Owner Lessee o:ntracto� sYA enVLO—r Qwner
g / (� g ,. MY COMMISSION#H
�-— :%! EXPIRES:August 8STATE OF FLO �� 'FaF f°e' lionded mru Notary Public
COUNTY OF
Swor . o(or affir d)and subscribed befor me of Physical Presence or Online Notarization
his t day of 20M by.
Name of person making statement.
Personally Kno OR P duc Identificati
Type ntification Produced
Signa ure of Notary"St-W-6rida)
g �M:"! YVETTE ELIZABETH PEPPARD
Commission No. (Seal) *: :,; MY COMMISSION#HH 000307
=m�, Q Q9- •EXPIRES:August 8,2024
�'FodF:�' Bonded ThruNOt81yPublicUndermitem
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 2 21
DR''vJE
Aj RECEIVED
i� Nov o 9 z ��
ST. Lucie County, Permitting
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