HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COM]i�-Eri ED FOR APPLICATION TO BE ACCEPTED ' a
Date: I - D a-LI Permit Number:
RECEIVED
s Building Permit Application sEP os 2021
Planning and Development Services st, 1<N910 t1Iy
Building and code Regulation Division Commercial Residentigotmio
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
i\O Cka Y\
Address:
Property Tax ID #: i��5' t)\ ' y ddV ^� Lot No.
Site Plan Name: Block No.
Project Name:
New Electrical Meter
'D b�,r�aw �,� ►,,,� �� ; lA
Second Electrical Meter
Additional work to be performed under this permit— check all
_Mechanical _ Gas Tank _ Gas Piping _
_� Electric
Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ S\
flop �, 6o
e
(Affidavit required)
iat apply:
Shutters _ Windows/Doors Pond
Generator Roof Pitch
I.
Sq. Ft. of First Floor:
Utilities: I Sewer - Septic
Building Height:
NameName"�gitk4 1rJ(JrJ
Address: Compahy:,y...` ^
City: �A . tV f-e State: Address: +'
Zip Code: ZLOy,I Fax: City: YL.0— State:
Phone No. 77a - '??7 — 6 P !OS Zi Code: Fax:
E-Mail: �(r '17-11 U oa wat Phi ne No
Fill in fee simple Title Holder on next page ( if different E-Mail
from the Owner listed above) State or County License
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.
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DESIGNER/ENGINEER:
Not A livable
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Md , TGAGE;COMRANY:
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Not Appl'Icabie
Name:
.Name:
Address:
aA}cictress,
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City:
State
Zip: Phone
Zip Phone
FEE SIMPLE TITLEHOLDER:
Not.Applicable -
BONDING COMPANY
=Not`Applicable
Name:
Address:
"address
,It i
"City.
Zip'K,. Phone
'
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby- ,made to obtain a permit to do th'e work'and instailation as indicated.
I certify that no work or installation has,commence i prior to the issuance`ofa permit
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St. Lucie County makes no representation that is.grantmg`a permit will autfiotize the permit ho(dertoibuild,the•subject structure ti
which is in conflict with any applicable` Home Owners Association'rules bylaws or'and.covenatits-that m66 .restrictofprohibit such
structure. Please consult with your Home Owners Association and ;reyiew your: deed for any restrictions:vuhich may apply. '.
In consideration of the granting of this requested permit, I do hereby agree`that I will, m ;all respects, perfo�rn the work'
in accordance with the approved plans, the Florida Building.Codes and St'. Lucie County Qinendments
The following building permit, applications are exempt from undergoing a' full concurrency. rev►ew room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms end accessory u,sei tdapotfrer hon resider►tial use • '
WARNING TO OWNER:, -Your faildri�tld Record a Notice of Commencement mayresul In paying finraceyfor,
improvements to your"property. A�Notice of Commencement must be recorded In`ith', 0-6bllc�rocords'ofSt
Lucie County an'd;'posted, on the jobsite,beffjre the,first in pect(on. If you intend tglobtaitn;flnaricfgg' consult
with lender or an ettorne before commencln ,work oe.recordin our,Notice of Comb eftib, iie " , ks '.
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Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF 6* . LUcc2
Swor to (or affirmed) and subscribed before me of Physicai Presence cr %On Notarization
this dayof -Skn 20_gS4 by ;
Name of person making statement.
Personally Known OR Produced Identification
T pe of Identification Produced 'DL
(Signature of Notary lic- State o DEAN t? iif �i0
ublic Sta pa6359
=`.tw vu�c : _.�otatY mission � H )an 18, 2025 r , ;
Commission No.� i�4 -k" __°: .'eall '
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REVIEWS FRONT 'ZONING SUPERVISOR. PLANS VEGETATION ' SEA TURTLE` MANGROVE
COUNTER REVIEW REVIEIIV REVI'E1N REVIEW RV�EW' REVIEW
DATE
RECEIVED • '
DATE
COMPLETED