HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED [�
�Date: �1' " ` d Permit Number: ��'y (P
ll0 15LU.lVL1� -�d-
RECEIVED
cw. ° Building Permit Application DEC �� 20L-
1
Planning and Development Services
St.Lucie Cou ty
Building and Code Regulation Division Commercial ResidentiatermitV
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LL�OnC'AATION:' `�
Address: C)"I G pp 9r`7'1`fAQW- � t.-V P (,
Property Tax ID#: 1 l00 A a f '-d�(��� Lot N 1 V46r,21
Site Plan Name: Block No. '7D
Project Name:
DETAILED DESCRIPTION OF WORK:
Cc AO U'Vos
��a.rp >F'��iC 1'w � S-
44yrY*4 0 to 4-
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
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ ' '- Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name )LIDIT14 L• A�(L'S1�9�1 Name: t��1JY�2
Address:"144�/001 ``g�o'rfya)5 ag)Lhuoo Company:
City: 7'L�:M�L',L State: Address:
Zip Code: Fax: City: State:
Phone No.11Z 62,5 dlg{(® I"112 t}-13 3`1'j 1 E- Zip Code: Fax:
Mail: e-GyY ML- 60YA Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
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.
SUPPLEMENTAL CONSTRUCTI N 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: _ 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 mayirestrict 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 attorney before commencing work or recording our Notice of Commencement.
dt',CZA_f C)'p c4umvv(_)
Si at re of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA Q
,COUNTY OF dJ
Sworn o(or affirmed)and subscribed before me of Physical Presence or Online Notarization
this day of. L' 2Q,)t by
YhC4WaJ n
Name of person making statement.
Personally Known OR Protitx a Identification
Type of Identification Produced
A Al h J--V .JV"
(Signature of Notary blic-State of Florida)
m Fes'•. AUDREY B.HUMPHREY
Commission No. Seal s'' b."t MY COMMISSION#GG 3008117
EXPIRES:March 6,2023
et~ oe`BondcdThruNotaryPublicUnde has
u•L�3.tiTilWP6.��+�'[ea'U:9R1iaWm':G.11ti'@i=:Y'.+.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5/20/21