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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ��-� �� Permit Number: 9Vo C.. c o 1 L 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: RECEIVED SEP 0 2 2021 St. Lucie County Permi� g PROPOSED IMPROVEMENT LOCATION: I AddressA(j'J()( �6v+k ©re" Drive _-Te -,n &ach . i'Lbr do S 6-% Property Tax ID #: gs-O2 - So ( p ©00 O" ©o©, a11 Lot No. Site Plan Name: A 0- 01 Af6k i LAM-0-1 �; )+e PICO Block No. Project Name: /7C_eQn GloS� AesdeYlG2 9-"?d M aLritl(k DETAILED DESCRIPTION OF WORK: ;den -la) hill W u.w 11 New Electrical Meter ✓ Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Additional work to be performed under this permit -check all that apply: l.✓ Mechanical _ Gas Tank —Gas Piping _ Shutters ✓' Windows/Doors _ Pond v/ Electric ✓Plumbing Sprinklers _ Generator ✓ Roof Pitch Total Sq. Ft of Construction: '4 636 Sq. Ft. of First Floor: Zi 56 4 Cost of Construction. $ 14 .lob, DQD. ©D Utilities: ✓ Sewer _ Septic Building Height: 92- i T OWNERAESSEE: . CONTRACTOR: Name =J224IC6S Ocean DP P_ lDQVee(,9Owlef4- LG p_4i R Name: Keiq iAQe, Company: (_yuieuf .eCLceS L LC — Address: 1`L'S i i1mr�e 5k'zro Address: M( SE !WwU AVeykw City: gau Ha�(.bcx SSI&'►ds State: 'FLL Zip Code: ?2 I �� Fax: City: vary State: L Phone No. O(3 ) 366- - 0936 E- Zip Code: Fax: Mail: ig.l R pLQ1Q! 1ir'DuD. GDP Phone No Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail State or County License`i51� 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 Name: r h� C-ardtier2L� Address: a E- City: A44a2+a State: 64 Zip: ?b�;a7 Phone 40 - ZZ0 - YQ66 FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: _ Address: City: Zip: Phone: MORTGAGE COMPANY: Name: Address: City: I State: Zip: Phone: BONDING COMPANY: V Not Applicable Name: _ Address: City: Zip: Phone: ✓ Not Applicable 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 County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording your Notice of Commencement. ( Q - is&= id - Signature of Owner/ Lessee/Contractor s Agent Owner STATE OF FLOR,�Q,�4 _ COUNTY OF i � AO d before V Physical Presence Online Notarization "Physical Sworn to (or affirmed) a sub cr[bed me of or this -A— day of (i 20 by Name of person making statement. Personally Known OR Produced Identification ti?"?�gc,; DOROTHYKROMBS Type o Identification Produced MY COMMISSION # GG 928111 EXPIRES:m 22, 2023 Wary ParyNovember Bonded Thublic Underwrenvrkers (Signature of Notary Pu c- State of Florida) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5720721