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HomeMy WebLinkAboutBuilding Permit Application ;1 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,1 Date: �\W Permit Number: 9 T. RECEIVED > ra Building Permit Application NOV 12 2021 Planning and Development Services St.Lucie ty Perr►� 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: Da't PROPOSED IMPROVEM�'pE'NT LOCATION Address: .5 3 I �G h(� I"�G�L S C: ! Property Tax ID#: I (D C-) —d 1 y "© ® O Lot No. I Lit) Site Plan Name: 4LPr� Block No. Project Name: DETAILED DESCRIPTION OF WORK:' SQ —G �� l e Jl U -�O - New Electrical Meter Second Electrical Meter (Affidavit required) _CONSTRUCTION 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:_ o Sq. Ft.of First Floor: Cost of Construction: $ �, O®C) CEO Utilities: —Sewer —Septic Building Height: 0WNER/.;LESSEE: ; .,CONTRACTOR: Name Name: l� Address: f3l c E rGlO Aou—.7 L' / Company: AuS LtG City: 15W State:E6 Address: S'Z ��-�l ��.$o �� r*U�-i C Zip Code: �/.S� Fax: City: POW SY State: rL Phone No. W2- 777_®S' © D Zip Code: 3 H el 97 Fax: E-Mail: Phone No -77 2 ZT(e --13 Y ke Fill in fee simple Title Holder on next page(if different E-Mail,-5-H.-- coc^' from the Owner listed above) State or County License 2294 19 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. 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 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 t our erty. A Notice of Commencement must be recorded in the public records of St. Lucie County a p ed on he jobsite before the first inspection. If you intend to obtain financing, consult with lender ttorne efore commencing work or recording our Notice of Commencement. SignatOwner/Lessee/Contractor as Agent for Owne ;)OF'IFLORIDA STAT COUNTY OF- Sworn - Sworn to(or affirmed)and subscribed before me of ysical Presence or Online Notarization this 2? day of QC_* 20 Z I by Name of person making stateme Personally Known OR Produced Identification Type of Identification Produced iAn"(: (Sibs ure of Notary Public-State f"Florida) Commission No. (Seal) HEATHER BURFORD ��-State of Florida-Notary Public _• •: Commission#GG 183217 i9�aF oP?;� My Commission Expires ��lllll�l� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 2 21