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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FCURWR CATION TO BE ACCEPTED 1 Date: 2z- 2( NpV 2 2 Z021 Permit Number: St.Lucie County Permitting Building Permit Application Planning and Development Services 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' )\iom C� 'BRO(.t31v PROPOSED,[IMPROVEMENT LOCATION: . Address: � ��5 � '� P(�)� �IV� + P� I ��c � � FL- 3 _ 15 Property Tax ID#: �J�-� �f�U�f�J �'- S ' t PNoWh. .�,7 7 g 11 Site Plan Name: SS bQyi� Pine ye-1y�� ��� Pl e,PTe r FLJOS] Block NoP-7ow h s Project Name: wkw% &OA C. BR0117(J NWl 60/1 --1r1 @2:q 900k fp�GLt Un,'1905 DETAILED DESCRIPTION OF WORK 'We-MOV aAa I�� lacev►1e k &41si n. )M t�Vr?" 00% 0,X e d arz �� I 7' o�x Iw AogAa ,Isb2lw Aaekle P 24 Ce over h e'd �0 `�Aq) �OD�,e� �y►e Dep �=L R dUc PA26V (�3`i I.1 a ND Zd -0q of ,90, New Electrical Meter N A- Second Electrical Meter 90 (Affidavit required) CONSTRUCTION INFORMATION: Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters V1fttlows/Door _Pond Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction:�l�i;�j�4� Q�4Dj2(C��'��$ Sq. Ft.of First Floor: i 2-k0+ 105 51 SF r Cost of Construction:$ Utilities: Sewer _Septic Building Height: —"3b OWNER/LESSEE: CONTRACTOR: _ Name__j M ay-n k©WOO Name: Address: Z-995 'Be.vlf Plri p ('RiV(2- Company: DO& © e Q f2QC1 2ECnp,5,-t City: State:EL Address:1ZI 9, 5 UV Zip Code: 3 `� Fax: M r" City: (D State: Bn- PhoneNo._ Sq'(o S !o a E- Zip Code: Fax: 2 2sz ' 33 Mail:_w 2yo 1&2-C©MC.0,S'6 , neA:7 Phon o 2' -41 ()ctr Fill in fee simple Title Holder on next page(if different E-Mail LoadeAe)oizsmJi e+q-' from the Owner listed above) ' State or County License 3 154 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. a.. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _X Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: OC FEE SIMPLE TITLE HOLDER: _X 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 consult 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 With lender or an attorney before commencing work or recording our Notice of Commencement. Signature.of;Owner/Lessee/Contractor as Agent for Owner STATE,OFLO FTRIDA► COUNTY,.OF Sworn to,(or.affirmed)and subscribed before me of " Physical Presence or Online Notarization this *22�lay of A.t3✓ 204RL—ay Name of person making statement. Personally Known OR Produced'Identification Type of Identification Produced � 1 _.. (Signature of Notary tate of Florida-Notary Fublie Commission#GG 276679 Commission No. , $e T.. My Commission Expired October 22, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED 11ev5/20/21