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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUSTS BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: `� a`�� a Permit Number: pL l r LJ RECEIVED O Building Permit Application DEC 3 o 2021 Planning and Development Services St.Lucie County Building and Code Regulation Division Commercial Residential Permitting 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 CBDG Funding. PERMIT APPLICATION FOR: PR�C}P05ED IM`PROVEMET LOCATION _ w Address: Property Tax ID# r,Z'l 02 C7 �`� yl)\ — �lJ� Lot No. Site Plan Name: Block No. Project Name: DETAILEQ`D`ECRIPTIQN OF 1tVQR1f .' �����' 2�c kh Cd rc.i.,i�' -tip ��ower M�/1P /���w�-►�'" C i s Yl 191 t) •© 2z�I New Electrical Meter Second Electrical Meter (Affidavit required) CON#STRUCTf iN'FORIVI'ATION Additional,work to be performed under this permit—check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors _Pond �ectric _Plumbing _Sprinklers —Generator Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ Utilities: _Sewer _Septic Building Height: OWiVERjESSE f CONTR'ACl"QR Name L ore - u�`- Name: - Address: Ayf '�,Soo Company: A i.)M a c . City: State:� Address: H q(t At s s U- ,, Zip Code: O 1'1 (a Fax: A)(A. City: '� State: Phone No. r171- %(b — 1CA1Ok E- Zip Code: 2M12 Fax: A-114 Mail: eA , Iake. are5-V' Q ±-imoLdn usvv% Phone No en). Fill in fee simple Title Holder on next page(if different E-Mail_j2 LJM e i A Cu from the Owner listed above) State or County License r C ] 3 D U 17,55 If value of construction is 25001 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 SUPPLEMENTAL.CONSTRUCTION LIEN-LAW WrORMAT(ONi. 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: i 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. 1 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 attorney before commencing work or recording our Notice of Commencement. Signatu tractor-or-Owner Builder as applicable STATE OF FLORIDA COUNTY OF Swo"to(or aft ed)and subscribed before me of Physical Presence or Online Notarization this, day of 2Q ]by .�. C�)�A1N,:,1J U)z� Name of person making statement. Personally Known OR Prodygej Identification Type of Iden fication Produced (Signature of Notary Public-State of Florida) Commission No. (Seal) KAREN S. NIELSEN State of Florida-Notary Public. =_ +. Commission # GG 207484 My Commission Expires June 12, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev 2 1 RECEIVED DEC 3 0 2021 61.Lucie County Permitting �a WA rc __ ij R. J e • E1 � �c►i�c, i