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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: RECEIVED Ol _, OCT 012021 Building Permit Application St.Lucie County Planning and Development Services Permitting 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: PRO POSED IMPROVEMENT LOCATION: . Address:. /y IYae, 45-n4dl E)R f_�_4"r Property Tax ID#: ?102--�g©Z s-O/za_Cot)""T Lot No. Site Plan Na &11&17_ zt�%fA Aff_-�r r f-+0i Block No. Project Name: la-- Awr DETAILED DESCRIPTION OF WORK: } Z"bep.-m-wr end O, C \ ! C New Electrical Meter Second Electrical Meter 7(_hifficlavit required) .CONSTRU.CTION 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: �r'o '!�Q 6� Sq. Ft.of First Floor: VC Cost of Construction: $ Utilities: —Sewer —Septic Building Height: OUVNER/LESSEE:. CONTRACTOR: Name 6 - Name: Address: Q T o`r, Company: City:T� ��eS-oc_ State: Address: Zip Code: Fax: City: State: Phone No. - © E- Zip Code: Fax: Mail: s C r Phone 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 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 conflicts with ay applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such structure.Please consu t 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. \\ a-_ 1-11,lzf SigriatureofOwner/Lessee/Co actor as Agent for Owner ;; `YP�a, HEATHER BURFORD i-State of Florida-Notary Public *_ Commission #GG 183217 STATE OF FLORIDA %TEOFFI My Commission Expires COUNTY OF �� �e- February 06, 2022 Sworn or affirmed a ?ubscribed bef re me of �h al Pr sence or Online Notarization this 191 day of�/ 2�by �j y 6 2n� - ? �u N P u Name of person making statement. Personally Kn0' tion Produ OR Produced Identif' o ✓ Type of Identifce (Signatu e f Notary Public-State of Florida) VMENNEA FINLE TER 22 �SAR q� Commission No. .41 (Seal) o� °, Notary Public o c State of Florida Comm#HH174135 .SINCE j9�� Expires 9/9/2025 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5/20/21