HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date : t 1 Z2 Permit Number:
° Building Permit Application
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 CBDG Funding
PERMIT APPLICATION FOR : vv Cc
PROPOSED IMPROVEMENT LOCATION :
Address : 4(o6o N AA t 4 QlteM_� 49 q(
Property Tax ID #: Lot No.
Site Plan Name : Block No.
Project Name :
DETAILED DESCRIPTION OF WORK :
6 L� �n � �- o w�u � �C YL )0 3 (0 3�ID✓� (7 �-✓
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 ctLac+. Name: P!L\n iC jAa4Q .,J4 ,A , 1- C>
Address: 4(00[) N (aIA Company: Y'Xc II M ICA�►v CGAcL k2Lat w —
City: V fgp -k Q iCrtc_ State: rL Address: Ict 3 (e Otn✓h fvy , (A.,
Zip Code: 34.44q Fax: City: lit U fie + . Stater(.
Phone No, E- Zip Code: Fax: �7 S'Iva
Mail : F Phone No.) ok ` 5 (02 - 2AG3
Fill in fee simple Title Holder on next page (if different E-Mail , Cla _ Q o oro
from the Owner listed above) State or County License cjq-cC n 1 aoTak�
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 CONSTRUCTION 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: Not Applicable BONDING COMPANY: of 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 concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNE : Your fai ure to Record a Notice of Commencement may result in paying twice for
improvements your pi rty. A Notice of Commencement must be recorded in the public records of St.
Lucie Coun d pos on he jobsite before the first inspection . If you intend to obtain financing, consult
with le r r an a r e b fore commencing work or recordin your Notice of Commencement.
For
nature(ef Co tractor - or - 0%vvier.Dhilcler as applicable
STATE OF FLORIDA
COUNTY OF , y1 � Q 1'J..c.
Sworn to (or affirmed) and subscribed before me of Physical Presence or _ Online Notarization
this � dayof .. QC n 202. Lby
IMn iL TV
Name of person making statement.
Personally Known . OR Produced Identification
Type of Identification Produced
IS n ure otary Public- State of Florida)
Commission No. � �� 31 � � • (Seal) R'Kw
ENN1FERGINADOLORESCRISAME
MY COMMISSION U HH3174
gxPlRPS: May 25, 2024
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev 10/ 12/21