HomeMy WebLinkAboutBuilding Permit Application All APPLICA LE TFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: N1' Permit Number:
fo ehu.C'U _ RECEIVED
r 0 <`
r ; JAN 14 2022
Building Permit Application
Lucie
Planning and Development Services I St Perrmittingnry
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-1578 CBDG Funding
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PERMIT APPLICATION FOR: i .4�j:»J
PROPOSED IIVIPROVEM:ENT LOCATIORI r
Address; o1� y`11 `�
Property Tax ID#: 00--A o Lot No.-
Site Plan Name:yCi 'V+r+f�������. CG S� ' �V�S1Q> Block No.
Project Name: 1 V`�-�i�
DETAILED.D.ESCRIPTION'OF WORK:.
�`�`���dw\. `vim�'�c.- ��c�t'c �s�,�►v.-'�.v�me� �r7� s _2-\[�3--'fl� �S� �\a v,
4d \A
New Electrical Meter Second Electrical Meter (Aff,idavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters ! Window s/Doors _Pond
_Electric Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq.. Ft of Construction: ilk `j = c�-- •�C'�; Sq. Ft.of First Floor:
Cost of Construction:$ i 60. 00 Utilities: —Sewer _Septic Building Height:
.OWN-ER/LESSEE CONTRACTOR:: .
Name ( �C� 1rOt`-28,� Div\� Name:
Address: \d�,�fLtJUQSS Ln(J� Company: 4.' +r�s �l•+w��►�•,c. Z,,
City:- k_�.k_1e State: t- Address: Z 5.6-/V /)i;k,t At,r
Zip Code: Fax: City: _LMr 5C_C-L1^ rL State:4
Phone No. �Q�C`��� E- Zip Code: 3�195 7 Fax: 17Z- 225= C72s9
Mail: Phone No 77z- ZZS-it,6I f
Fill in fee simple Title Holder on next page(if different E-Mail !GC C `if 371 Com
from the Owner listed above) State or County License G F L i q L J ZU Y
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 CONSTRUCTJON 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: of 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 w th 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 er or an a orne before commencn work or recordin our, Notice of Commencement.
Signs a of Contract or-Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF VJ t'��J
I VI
Sworn to(or affirm)and subscribed before me of Physical P esence or Online N°otarization
this�day of 20?3by J S� i j i(� 7,
Name of person making statement.
Personally Known OR Pr uced Identification 0
Type of Identi ion Produced Juve(
(Signature o ota ublic-State of Florida)
Commission No. Seal Wx;
'►�� Notary Public State of Florida
( ) Laura Arguelles Alonso
My Commission HH 080202 Expires 0211512025
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEAITURTLE MANGROVE
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DATE
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