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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: • I? nv. .�© SEP 2 12021 ' St. Lucie county Building Permit Application 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 CBDG Funding PERMIT APPLICATION FOR: '�> 17 k Address: I� ;a111W - 11RIr k z Property Tax ID #: �()2�(P q - U l U - ' Lot No. 2L] Site Plan Name: Block No. _)� New Electrical Meter V Second Electrical Meter (Affidavit required) Additional work to be performed under this permit- check all that apply: "Monechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond _ Electric V Plumbing _ Sprinklers _ Generator Roof Pitch Total Sq. Ft of Construction: 2 J152 Sq. Ft. of First Floor: 1�34 Cost of Construction: $ Utilities: _ Sewer Septic Building Height: 10) 3' '� AS"` 5"$^,i i i �*r:'�1k3 .+Ai. €: R'i� � 1 15 ; 4��� �' � -F't9 `: Fd. r^'ras tk k'' dRF 'i y� I■. �� �:r L (,"��g�:.x � ��iva�� 1Y, `&',�F'"m✓iSii'y�1i�� � �,,� �`�5 3 ONE, e^. b b i i h '+.� 4 �, i aE:s%" : .�""... Sa N " .' �. i , r. r`af.�.at�d��f � .€ t. .. :.t+k b,i �3. �., 3.,�,n .�rd $,. - `i.i�i K�r�'. , �� �� �'`i,�., > >�r Yf +" . r..�,...... E ,Ja_..T..Fx ,'�S F.e.; �# f�� „_r.,�S .,.... x,� :. ,.v,, w,.)��.,�:�� .A•,e:,..:: Name ZlA,nm Nkey-y-it+ Name: 30a)n menrlr1 Address i L)eY1 /Q I7d Dr Company: —VkT 1 ICE Address: qN ni) 1"I maac (lik _00 City: -Yi oercel StateP City:f6d , ��Q State Zip Code: b2 Fax,: ' t I Phone No. _712 �iU-g14W E- Zip Code: Fax: Mail:_t �lkl I U2YSI I Gi�, CMJ(YY�iA� . i�t ` Phone No ��� - ,3�- L4A 24M 0 Fill in fee simple Title Holder on next page (if different E-Mai hL6 I Jpr 5r IC, 2 _C0(YYCII'L1<4-.rt 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 $7,500 or more, a RECORDED Notice of Commencement is required. vRL•i..�i SIR�GT ��+i {��i` N'A"`.✓e'+� i ¢ }$�^'SAr' ��'�RS'.i�e# w n :?k $2 �` %:.Y�"rS�'I'�,c2 DESIGN /ENGINEER: _ Not Applicable MORTGAGE COMPANY: of Applicable Name: Name: Address: 1 Address: City: Q_ Stated City: State: Zip: F�1-4 Phone -1-I-,!)-1�35-gR98 Zip: Phone: FEE SIMPLE TITLE HOLDER: _ of 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 attornev before commencini; work or recording your Notice of Commencement. Sign re of Ovgi&71e7ssee7contractor as Agent for Owner STATE OF FLORIDA. COUNTY OF cWC el Sworn to (or affirmed) and subscribed be ore me of Physical Presence or Online Notarization 'day of 2by thisICALOD LAf rr* Name of person maki g statement. Personally Known OR Produced Identification Type of Identification Produced (Signatur4 of Notary Public- tate of F rp a) Commission No. I) MELISSA ANN MCLEOD commission H HH 15221 _°: �� ��`: Notary Public - State of Flo]Assn. a• ot.F�°o-, My Comm. Expires Jul 12, Bonded through National Notary REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5 1