HomeMy WebLinkAboutBuilding Permit Package All APPLICABLE INFO MUST BE C.0MPLE*r FOR APPLICATION TO BE ACCEPTED
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Date: Permit Number:
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p - t . � Building Permit Application /RECEIVED
Planning and Development Services NOV 3
Building and Code Regulation Division Commercial Residential o �02,
2300 Virginia Avenue,Fort Pierce FL 34982 t.Lucie County
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding Permitting
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: [��3 -5 �/Lt-"a/r% / � .34 z
Property Tax ID#: Lot No.
Site Plan Name: 7_/Z,')/,/Zd,G L Z r/,!J ��.�� `�� Block No.
Project Name:
DETAILED-DESCRIPTION OF WORK;
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION.INFORMATION:
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond
XElectric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ ��� Utilities: —Sewer _Septic Building Height:
OWNER/LES$E/E: 'CONTRACTOR: i
Name,�l//r�l Q�3LD L� D/�E/Zl/ Name: zzz�_ Z
Address: 1.5�iJ��,Ci:¢fUD ��� Company:
City: eQ/Le=3�. X-/l Z/?- State: A-Z_ Address:
Zip Code: 3:5�,q 6 Z_ Fax: City: - Stater
Phone No. E- Zip Code: Fax:�lJ ,��GD
Mail: Phone No
Fill in fee simple Title Holder on next page (if different E-Mail 1_i'z l /1 Q�/JY� ��.er��=IG �G
from the Owner listed above) State or County License
L
ue of construction is 2500 or more,a RECORDED Notice of Commencement is required.
ue 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 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,
accessorystructures swimming pools,fences walls signs,screen rooms and accessory uses to anothernon-residential g p g ry 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.
2
Signature of Contractor-or-Owner Builder as applicable
STATE OF FLORIDA
COUNTY C ��
Sworn t (or affirmed)an subscribed before me of _�hysical Presence or Online Notarization
this Iay of ,,COI, ,2Q.-:�[by
Name of person making statement.
Personally Knownt,-� OR Produced Identification
Type of Identification Produced
4Z6;)6"
(Si gnaturre ofTVotary.Pub' -State of Florida)
Commission o.^ r I -_PEDF69k0N80 {
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* ;Cammission#GG 297802
Expires February 23,202S
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REVIEWS--__, .FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev 10/12/21
_ RECEIVED-.
Nov 0 2021
St.Lucie.County
Permdting
5951 NW 201 LN-MIAMI-FL 33015
Phone(305)e20-7884
EC130085M
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Uzi✓ ,�� .l�D��6-46'Zi
G��l'�lz- vUB��o PEDRO M ALONSO �!
Commission#GG 297802
Expires February 23,2023
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