HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: U, kA! zk Permit Number:
gam. Luu�' "1JC
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce F! 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: \d
PROPOSED IMPROVEMENT LOCATION:
Address: 2.-GU V 1t�r"�.i -�)\/\tif.)
Property Tax ID #: 2 iZ-0 _ Q — 2 - Lot No.
Site Plan Name: Pdya V InC. Block No. '--
Project Name: A I V0 V
N OF WORK:
C,
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
11
(Affidavit required)
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 c_ Roof Pitch
Total Sq. Ft of Construction: i j3 V Sq. Ft. of First Floor: L's Q= I j V-\j
Cost of Construction: $ C 4CC • Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name
Name: ► j
Company: I ilC
Address: S� unas�
City: ia2. a Pin- c R
Zip Code: �`�CI`� - 1 Fax:
Phone No -i-�
State:
Address: 2' \/\'yti V
- r
City: , State: =
Zip Code: Fax:
Phone No. E-
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail Cam' S�G
\ \ . �.r`Y1/'1
State or County Lie e
CKCw
it value or construction is zsuu or more, a 1AMUM)Eo 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:
DESIGNERANGINEER:
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:
V VVIVLR/ LUIV I KALI UK AYFIIJVI I: 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 consu t 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 attornev before commencing work or recordin our Notice of C
ommencement.
Signature of Contractor-- or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF
Swor to (or affirmed) and subscribed before me of
this day of_ V? 2n0- by
Physical Presence or Online Notarization
S�
Name of person making statement.
Personally Known. OR Produced Identification
Type of I tific '
(Signat of N u ic- State of Florida)
Commission No. (Seal)
rr KATHERINE HAVENS
O1.. V�
r; � MY COMMISSION #HH199309
EXPIRES: DEC 04, 2025
Bonded through 1st State Insurance
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Pv 10/12/21