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HomeMy WebLinkAboutBuilding Permit Applicationkil APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ns� Date: Permit �� p Permit Number: q' RECEIVED C o .�..�I• ..•••...�. SEP 2 3 2021 1. I.J rt1 Building Permit Application St. Lude aunty Permitting 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: Property Tax lD #: 13 0 L G - O S? —��C% Site Plan Name: Lcje w -o©,J 024r A - On 1 6 Proiect Name: Maim Flartriml nnetPr v*" Second Electrical Meter, Lot No. Block No. G Additional work to be performed under this permit -check all that apply: _✓Mechanical _Gas Tank —Gas Piping _. Shutters 0 indows/Doors Pond V(Iectric _Plumbing _Sprinklers ._ Generator ✓Roof Pitch �� 7, 6 3 — Total Sq. Ft of Construction: Sq. Ft. of First Floor: �._ Cost of Construction: $ I gam. 5240 Utilities: _Sewer Septic Building Height: Name Address: — City: e 2 : & State: �4- Zip Code: _3 16'o Fax: Phone No. E-Mail: a ` Fill in fee simple Title Holder on next page ( if different from the owner listed above) - Name: _-t?-4, Company:" Address: City: _ Y=�. a �- c.e Zip Code: lu 9 c Fax: Phone No a- f-Mail a 5� C c.. State or County License 'SS i 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. 3 DESIGNER/ENGINEER: _ Not Applicable Name: "ble_ko ,e Address: 44 b I 661a City: 1=a. Q; cr•ce State: _F Zip: Z�g q G Phone ('771) 'lost - Loa 3 FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: _ Not Applicable Name: Lmcj-_ ".WA,a� Address: Too c co. sA. City: F-04 Q►4..-Ce State: )tL Zip: Phone: 77 a - y BONDING COMPANY: Not Applicable Name:_ Address: City:_ 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 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 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 your Notice of Commencement. nature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA �� 11 STATE OF FLORIDA Q: Lu llt COUNTY OF U�. L(G COUNTY OF VT Sw7n to (or affirmed) and subscribed before me of Physical Prue tce or Online Notarization this - day of _ 202& by 6w� ID . C` c�, A� W\- Name of person making statement. Personally Known 1'1� OR Produced Identification Type of Identification Produced n A (Signature of Notary Public- S C ooar ►u� Notary Public State of 17q0, a Lea Askman Commission NO. ommission GG 1• �"ora Expirbs0110912022 REVIEWS I FRONT I ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED Swory to (or affirmed) and subscribed before me of ✓ Physical Presence or Online Notarization this day of . 2020 by Name of person making statement. Personally Known Le OR Produced Identification Type of Identification iature of Notary+ Public- S+ mission No. �y 17g6j�' SUPERVISOR I PLANS I VEGETATION REVIEW REVIEW REVIEW -, d rary Public State of nna Lea Askman � My Commission GG 17 a WeM) 01/09/2022 SEA TURTLE I MANGROVE REVIEW REVIEW