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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO_BE ACCEPTED Date: a1 a Permit Number:` - 063y RECEIVED r SEP 212021 Building Permit Application fit, nrl aKNntr Planning and Development Services N�'T iuing 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: � .1:;: _ �kti.-_r ;�.-�' ." .',N '-Z`-q'.»i. Address: Property Tax ID#: ��a�J S�ro a�ad fd� Lot No. Site Plan Name: Block No. Project Name: t h •C p��/,r'4''r e �„� i} �,� 4" �. �^ �( C, 1 "' S y Yy.,4>��'' ais�r. :?�T,�v. �. ,_:.t.� " .�,� ..:,s ri�4fx'�. �. �"tlz�,.,.3..G.'2" ;�''I.,.y::.,� t� _..s,W. }� 3 �t��i�.��^cx+�...-a•'-=.r , car n New Electrical Meter Second Electrical Meter (Affidavit required) y 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: �..,k — e a -,s,h; 3 y u_s" z•�.n ma's - x ,. - -�;4�--� ...�:�7 3��_3c�r - Name sb- 6 1 ,P— 6 Name: � f Address: Company: t L I� City: ikk SJn �� l:arl: State. Address: ITV Zip Code: 3q Fax,:] State: f Phone No. � ���1 �,�©`i� .i E-,: Zip Code: Fax: Mail:- �5 �Z��� CL�h�l itl 1:.= : .::._ _......_.... ,- Phone No 01 Fill in fee simple Title Holder on next page (if different E-Mail 0- 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. WINS.�.,?' -.:r,.. 0 '��a.N... �., s&I.a -11- WINr" '�2-. ]�-. 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 concurrehcy 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 lgpder or an aArne,y before commencing work or recording our Notice of Commencement. Signature of Owner/Lessee/Contractor s Agent for Owner STATE OF FLORID COUNTY OF Sworn to(or affirm ad and subscribed b fore me of Physical Presence or Online Notarization thi t of . 2 by Name of person making statement. Personal) Known OR Prod ced Identification Type of I ification ProducedL (SignakZr,w6f Not ry Public-State of Florida) QJ Commission No. (Seal) LASHAHNAINGRAM-RAHMING rF REVIEWS FRONT ZONING SUP g;'h' m -BOM. i t=N ;, SEATURTLE MANGROVE COUNTER REVIEW R — _ REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 20 2