HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: Q
Olt i? r CE :v RECEIVED
DEC 3 0 2021
9 -•. D - - Building Permit'Application
St.Lucie County
Planning and Development Services
Permitting
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:
- - -
-
MARE
Address: 2. 2 if.. . N, S T
Property Tax ID#: /y !3 - 01 ��r w �`' ,7 _ Lot No.
Site Plan Name: Block No.
Project Name:
NNE
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p,� rIn o dam•_ 4 .a;p J✓,oe�-a �.��
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New Electrical Meter. Second Electrical Meter (Affidavit required) �J
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:.
_ .. ee " ,r �- s �-r` " - s" _- � .r+•- _ `as''re==: ems- 'r" _
s
~Name r0 '� Name Uiyt<i L
Address: 2.211, PJ L13 f Q S 7' Company: ' �.�`.v►,�r+ E c:Gca���� men'
�T *?&rcr e State: F Address; DF} Cite-
city:
i-A�'d t +A'Ce
Zip Code: 34 cl h Io Fax: City: Pie r L G P State:FnL-
Phone No. t-k S-- t I '� --^^ Zip Code:',(I C161 Fax:
E-Mail: &4Xey- ' Phone No 7
Fill in fee simple Title Holder on next page(if different E-Mail C. S' -t N2fy;'C�0S C �l-� o
from the Owner listed above) State or County License F t J 30C2Q1-iN3
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.
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 is in conflict with any applicable Home Owners Association rules,bylaws or and covenants thaVmay 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,•perfor*rri.,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 a,nd posted on,the jobsite before the first,inspection. �f you intend to obtain financing, consult
with lender or an attorney before commencing work or' "recording our Notice of•tommencement:
Signature of 0 ner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA _
COUNTY OF
Swo o(or affi ed)and subscribed before me of _Physical Presence or Online Notarization
thi day of 2CL1j by
Name of person making statement.
Personally Known OR Produc Identification
Type of Identifi tion Produced
(Signature of-Notary Public-State of Florida
Commission No.
KAR•EN_S. NIELSEN
State of Florida-Notary Public -- -
_+ *_ Commission # GG 207484
M Commission Expires
-June s }n
REVIEWS FIR IM R ISOR PLANS VEGETATLON SEATU.RTLE_ . MANGROVE
COUNTER REVIEW , REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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