HomeMy WebLinkAboutBuilding Permit Application 11/17/2021 WED 12, 08 FAX 772 3367566 AC Advantage, inc. U001/003
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 2
Date: Permit Number:LF
Building Permit Application
Planning and Development Services J
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax. (772)462-1578 CBDG Funding
PERMIT APPLICATION FOR; Ac- o_�auQe ej_t� on
Address: , rJt � ,] 6AC PLV-V D�
Property Tax ID#: �--1 � �_�_C �� ' ccc� Lot No.
Site Plan Name: Block No.
Project Name:
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New Electrical Meter Second Electrical Meter (Affidavit required)
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AdditlonaI 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: $ 42--scz," Utilities: _Sewer _Septic Building Height:
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Name v"an Name: 1 A�r�_ CaJAA.LIA_
Address' 1�6 �V Company: � , •/C�V��t�¢¢� Lltic
City:�..d1�_lL��.C.l � „ _ State:�. Address: �gZQ, 6 _2 7 L�+vLcS to �.
Zip Code: �5!( Fax: City: ��L Ct_e State:
Phone No. E- Zip Code:�ac� Fax: 1�- !�'-iSC J;
Mail: Phone No
Fill in fee simple Title Holder on next page(if different E-Mail l Get ' tti C;Ovv1
from the Owner listed above) State or County License •�dVleL
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.
11/17/2021 WED 12: 09 FAX 772 3367566 AC Advantage, inc. i�j402/403
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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 Isanting a permit will authorize the permit holder to build the subject structure
which conflicts with any applicable Homeowners ssoclation rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with gr 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 jobslte before the first inspection. If you Intend to obtain financing, consult
wit ender or an attorney before commencing work or recording our Notice of Commencement.
S nature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF _--;A L gL ,
Sworn to(or afflr ed)and subscribed before me of Physical Presence or Online Notarization
this V_k day of c;,/ 20-4 by
Name of person making statement.
Personally Known Q OR Produced Identification
Type of Identification Prod c
(Sig ature f Notary Public-State of Florida)
Jamie Perna
Commission No. Awk,NOVANIFUI3LIC
ATE OF FLORIDA
M.X "00267323
Expires 101Pa12022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETCD
ev 5/20/21