HomeMy WebLinkAboutBuilding Permit Application I
I
AIIIAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
RECEIVED
WOE � NOV 0 3 N21
r._ 0,T l,ugla 00uncy
i Building Permit Application Permitting
Planning and Development Services
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 tr.,. � � Gd� � Cev�
PIQPED IMWROVEMENT LOC/�TION:
OS
Address: ���u . .r� � h �or� :c-SG� �► 9
Property Tax ID#: Z`�a'1 1�Q — Lot No.--5—
Block No.
Site Plan Name:
P iolect Name
1: x '
Dlj�
ECRfP }IONQF Wt?RK �f
.
l New Electrical Meter Second Electrical Meter
I
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: �� QQ:) Sq. Ft.of First Floor:
Cost of Construction:$ o' Utilities: —Sewer _Septic Building Height:
k
OWNED/LESS'EE ,�_.
. . .-ti . -._ nl h�'.;
m rn Name
�� :
Address: 900 ) Company: SQL /-::;
City:
�� g r�� State: L Address: �G �� �l
Zip Code:
"74 Fax: City: .�=,�.�i G/c� C /,,- State
Phone No. —` J� 5— 7 49,45- Zip Code: 'S S/T(slJ Fax:
E-Mail: , A - Phone No 17`a S
Fill in fee simple Title Holder on next page(if different E-Mail Jo �Z—/j
from the Owner listed above) State or County License
�If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
ent is required.
if value of HAVC is$7,500 or more,a RECORDED Notice of Commencem
I
SUPPj.EMENTAL CONSTRUCTION LIEN�LAW 1N `
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 that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
Inc onsideration of the granting of this requested permit,I do hereby agree that(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 o n c3ttorwavelbre cpnimencing work or recording our Notice of Commencement.
I
Si' o n er/ see/Contractor ner Signature of Contractor/License Holder
i
TE OF FLORIDA STATE OF FLORIDA
COUNTY OF_5�b. Luc;. COUNTY OF
Sworn to(or affirmed)and subscribed before me_of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
�
this day of yt�aJ .2024 by this day of 2020 by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Pr oduced Produced
OEANNA GIVENS
(Signature of Nofdry Pub F, lion Y HH 086359 (Signature of Notary Public-State of Florida)
aE
My Comm.Expires Jan 29,2025
Coission NoA `�� tional Nbtary Assn,
Commission J "" �� onded thr � Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED 71
Rev.