HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: necelvea Permit Number: 0C W11:_ dLfz
NOV
01T. dC� cm St. Luce 2 2021
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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
PERMIT APPLICATION FOR:
Address:
29
Property Tax ID #: C30a , 4' Lot No.
Site Plan Name: ozay 6? Block No.
Project Name: T—�/2
New Electrical Meter Second Electrical Meter
Addit'onal work to be performed under this permit —check all that apply:
i
_Mechanical _ Gas Tank _ Gas Piping —Shutters ` Wind'ows/Doors _ Pond
Electric Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: I��� Sq. Ft. of First Floo
Cost of Construction: $ 15 n C'7C''3 Utilities: —Sewer 2eptic Building Height:
YY
OWNER/LE�SSEE.�r rj s
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CEO TRACzTC)R 3�,4~y s��
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Name
Address:_/jB L 7,2_ Y bi,
Company:
City: 4:e_ &pyCQ, Stat,e:E
Address:
Zip Code:9� Fax: -
City: /r,ay iiDi'�`o State:
Phone No. 7 7Zi�" �h,
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Phone No 77Z���Z—
E-Mail:
Fill in fee simple Title Holder on next page (if different
E-Mail Z2.1
from the Owner listed above)
State or County License Z&& Z 3!
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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OWNER/ CONTRACTOR AFFIDVIT: Application is hereby maoe w ootwin a Pul IML LV-
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 aying twice for
improvements to your property: A Notice of Commencement. must be recorde in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you inten to obtain financing, consult
with lender or an attorney before commencing work or recordin our Notic of Commencement.
as Agent for Owner I Signatu
STATE OF FLORI W(� STATE COUNTY FLU IJA
COUNTY OF � 7
Sworn to (or a armed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of Physical P sence or Online Notarization
-•# hysical Presence or Online Notarization this ay of 2020 by
this day of a%WAS , 202Q by
Name of person making statement. Na a of person maki statement.
Personally Known OR Produced Identification ersonally Known OR Produced Identification
Type of Identification Type of Identification
Produced
Produced
(Signature of Notary Public- S
Commission No. ttgyl'
REVIEWS I FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
re of Notary Public- State of Florida ) .
KELLY DELVALLE fission No. (Seal)
Lary Public - State of FI ridgy
Commission # HH 011.6 6
SUPERw'wVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW FREVIEW REVIEW REVIEW REVIEW