HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST B�COMPLY!,J ff APPLICATION TO BE ACCEPTED
Date: Permit Number:
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° < 5t.Lucle.County
Permitting
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:
Pi OPQSED IMPRQVEM�IVT LOCATIQN .,��..
Address: !OD/ Ely1E'/� 0 Add .
Property Tax ID#: �i♦7 L13' 06 W ' 400 3 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESGRIPTION.�OF WC+RK �
New Electrical Meter Second Electrical Meter (Affidavit required)
CC NSTRUCTION INFORMAM
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.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: Sq. Ft. of First Floor:
Cost of Construction:$ /I (��l Utilities: _Sewer _Septic Building Height:
QVt ft "LESSEE
CQNTRACTQR
Name 7RAStI �DAsf Ca�s�J�i�0lA1 o.4QiN.G 3 Name:
Address: 60(e !/Gl9 Al ^s, ''' Com an ' f�GTU>�E_ C'O�✓
p'. ..Y'
City: VW ��dCtl State: FL Address:'ki
Zip Code: 37-9&3 Fax: 4 City: State:
Phone No. I17 7. 8636 Zip Code: �yCl7 '.� Fax:
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E-Mail: O D e !ro . 60/{ Phone No 772 Zls 6 3 I
Fill in fee simple Atle Holder on next page (if different- E-Mail Jr-Lac_ 61';cZr1 �B Qo •�o•�
from the Owner listed above) State or County License C 6 06-10V
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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SllPRLEMENTAL CUNSTRUCTIC)N11F LAW fNFC3RMATIC3N _ M� �. �q
DESIGNER/ENGINEER: _.r=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 is in conflict with any applicable Home Owners Association rules, bylaws or anti 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 our Notice of Commencement.
Signature of wner/Lessee/Contractor as Agent for"Owner
STATE OF FLORIDA
COUNTY OF
Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization
this day of P0-2H 20�[ by 0B
Name of person making statement.
Personally Known I OR Produced Identification
Type of Identification Produced
(Signature of Notary Public-State of Florida)
Commission No. �s� 3 (Seal).. SOW=Ful.AcState teteorFloride
onnelln GG 248323022
REVIEWS FRONT ZONING 'SUPERVISOR PLANS VEGETATION `SEATURTLE .MANGROVE
COUNTER- REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5/20/21
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