HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INIlFC+ MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I �Di. Permit Number:
RECEIVED
13 2022
k i Bullldrl SACat90rB St.Lucie County
g Permit A p p Permitting
Planning and Development Services
Building and Code Regulation Division . Com'mercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
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Address:
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Property Tax ID #: � � � a �� Lot No.
Site Plan Name: Block No.
Project Name: t
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New Electrical Meter Second Electrical Meter (Affidavit required)
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Additional work to be performed under this permit-check all that apply:
Mechanical Gas Tank _Gas Piping _Shutters _Windows/Doo'rs • Pond'
Electric —Plumbing _Sprinklers —Generator _Roof Pitch
Total Sq. Ft of Construction: r���� GI �ct�-�Cc� Sq. Ft.-of First Floor:.
Cost of Construction: $ Utilities: _Sewer ' —Septic ` ; Building Height:
4 yap].{..r. {. �,..- s ,s•trz'^ l,r -.Y' ".' A r"G .��`-�
K. .. `p
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Name IL M, U GNU o L' Name:
Address: ' llrL 1 - 4' � -' Company:
City: pi V14 - .-- L State: Address:
Zip Code: Fax: I City: State:
Phone No.�1— �� 0 T/l E- Zip Code: Fax:
Mail: Phone No
Fill in fee simple Title Holder on next.page (if different E-Mail
from the Owner listed above) State or County License
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.
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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 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 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 C y and posted on the jobsite before the first inspection. If you intend to obtain financing; consult
with nde an attorney before commencing work or recordingour Notice of Commencement.
Si ture of Con actor- _own
r Builder as appiica e
TATE OF FLORIDA .
COUNTY OF
Sworn to(or affir ed and subscribed befS�ree me of physical Presence or Online Notarization
this 4 day of 2=y
Dud.
4�m_ of
Name of person Waking statement.
Personally Known OR Pr Identification ;
Type of Identification Produced lrr-
A'U
(Signature of N t ry Public-State of Flor a) _ t,
a„4 - AUDREY B.HUMP}IREY7-
Commission No. (Seal) '"= mycommisSI0tJ#GG300817 +
-�' ";� T EXPIRES-March 6.20L3
bonded Thru Notary Public Underrit2rs
REVIEWS FRONT ZONING SUPERVISOR .PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev 10/12/21