HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 11-11-21All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 111 ! 11 Permit Number:
it 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
PERMIT APPLICATION FOR: �j►r1d�v.a lQCeaMer� �-
PRO POSED IMPROVEMENT LOCATION:
Address: P1
Property Tax I D #: ( So t t q w Od 7 S Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Block No.
Additional work to be performed under this permit —check all that apply:
Mechanical Gas Tank —Gas Piping Shutters X_Windows/Doors _ Pond
Electric Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 55 l • 3.�_
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: I CON-
Name T (yNNM►�ys Name
Address: SS 10 Y__iNXO"YntComp;
City: rrovk 'P State: l Addre
Zip Code: 34AS Fax: City: I
Phone No. 35Lv " 34 5 — l L4 Zip Ca
E-Mail: T1n Y ►S c Phone
Fill in fee simple Title Holder on next page (if different E-Mai
from the Owner listed above) State
•RACTOR:
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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:
State:
City:
State:
City:
Zip: Phone
Zi p: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
_4. _
ai
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permli to uu ure wo n IU !!l310l4[ 14V44 4,. u 4
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
structure. Pleasecconsult with your Home Owners Assoc ation and review your deed or any restrictions which may arict or l. prohibit such
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
improvemen o your property. A Notice of Commencement must be r orded in the public records of St.
Lucie Cou and posted on the jobsite before the first inspection. if u intend to obtain financing, consult
with le r or an attorney before commencingwork or recordin ur Notice of Cam cement.
of Ownef
STATE OF FLORIDA J
COUNTY OF <q L
for Owner
5wor o (or affirmed) and subscribed before me of
Ph��((-s-ica! Presence or Online No rization
this fV'day of Nib = , 20Zby
01 C(,l•i!a eL, -1 . & p Z 1
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
— 7LfMA DARDFN
Notary Public - Stale of Florida
of Not = I St&LG• Fi �Ec 18. 2021
.„ Bundr�d thrcugil iVallonal Nol!iry Assn.
Commission No.
REVIEWS I FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
COMPLETED
51gnure or [AUr/LILeMA-Z Ru4uc! --
STA F FLORIDA f%
COUNTY OF (�
Swc�rn�o (or affirmed) and subscribed before me of
Vh,,y1�,s,i�cal Presence or Online-No�nzation
this _""day of �je "" Z� lby
Name of person making statement.
Personally Known V OR Produced Identification
Type of Identification
Produ ed
nt v_,4 DARQFN
Public -
.Notary Public -State 4f Florida
tr, Cnmm" s'
6frpfb�"+ Dec 18 2021
(Signature o Notar B0ndF.4111rC;L: af;on2liJot3ryAssn.
Commission No.
$UPERVISREVIEWOR� PLANS REVIEW I VEGETATIEV EWON I SEATURTREV EWES I MREVIEWVE