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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 1 All APPUCAB E INZOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 (. t ri Date: V�J Permit Number:�1 V;L-�V ") `, I 9 o LU,cllL N;:7 DECEIVED 71 LU UO U c. ) - Building Permit Apphcafa©n DEC .i ' 2021,11 Planning and Development Services St.Lucie untr Building and Code Regulation Division Commercial Residential Permitti 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding -PERMIT APPLICATION FOR: P:ROPO:SED<:IMPROVEM.ENT LOCATION: Address: Property Tax ID#: a �� 331 r �� 'oC� Lot No. Site Plan Name: / . Block No. Project Name: \' DETAILED D-ESCRIPTIQN OF WORK: out 7s New Electrical Meter Second Electrical Meter (Affidavit required) C:ONST_RUGTION'I:NFO;RIVIATION: Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank —Gas Piping _Shutters _Windows/ ors r Pond *� _Electric _Plumbing Sprinklers _Generator oof Loa 1 --Pitch Total Sq. Ft of Construction: -,�L Sq. Ft. of First Floor: Cost of Construction: $ � � Utilities: _Sewer _Septic Building Height: 0.W,N R/LESSEE: CONTRACTOR: Name Name: _ Address: `jQ Company: Vt dMead-ot- City: '' Q,�((P, State: Address: z Nth '-ra11&, Zip Code: Fax: City: -State: Phone No. `1-1 17 ` �s i E- Zip Code: 3qC�� Fax: mail: �Vn � �9�1t������• Phone No 1 lfo —TJGT7 - Fill in fee simple Title Holder on next page (if different E-mail from the Owner listed above) State J County License M 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. I :S.UP:PLEMENTAL:CONSTRtJ.CT10{V 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, accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use WARNING TO OWNER:Your failure io 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 ner/Lessee/Contra . or as Agent for Owner STATE OF FLORID COUNTY OFl�c°� Savor�t,4�(or affix an subs ribed before me of -� Physical Presence or Online Notarization this /( lday of Yl ,20�by Name of person making st ment. DENISE ELAINE SUAREZ Personally Known OR Produced IdentificationNotary Public-State of Florida Type o dentification Produ d � �' Commission M HH 52897 .= %��a.��Q•� My Commission Expires ig ature of Notary Public-State of rida) Commission No. ��' 'lS al) F VIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW EEIVED DATE COMPLETED ev5/20/21