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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: A&'9A-'P 9U.LUC E � J A N 1 1; 2J22 y'G,. St.Lucie;County P EL ° a 0 ° � `'`` Building Permit Application Permitting Planning and Development Services Building and Code Regulation Division Commercial Residential i 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax:(772)462-1578 CBDG Funding PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: Address: 74o5 oioi-bm RoA' , /=/. AEACE EL 341S_ I Property Tax ID#: 1 ,250 1 -605�-O.oyg -00O d-4- Lot No. /7 Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: RiE.MoV IN6 EX i 5TIN G ASPJf A j '5ItIA)G LF-5 F`Rb®i=�nt� W i I H Ti Mi3 Ci;L-J r�l ItI�Z cif in1G L�F s New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: 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 Vnd Roof Pitch Total Sq.Ft of Construction: 2.222 6F QooF Sq. Ft.of First Floor: 1 3 ZU Cost of Construction:$ 4000 Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR!: Name EY E iVlil E 1 8-5-0 IQ Name: Address: 7 4-o S DoiiLotj /?©A 1�. Company: City: lrT- i�R,Cer State: FL- Address: Zip Code: 34-95\ Fax: City: State: Phone No. 772 ) 332. 9 34-2— E- Zip Code: Fax: Mail: C-A i &55&iQ 349& P rvIA►i--Co 6A 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. i 1\ 1 SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: (?OcKe.l M09-16AGE, ." C Address: Addr ss: O5"ol Qo�� I�tJAVE . City: State: City:Te7ni,D I-r State: Zip: Phone Zip: FZz-& hone: L FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: C+IEYEIJNF_ Gr65_04 Name: Address: 1 OS oO --vN Address: City: f=T. P e(Zce . L 349✓r_1 City: Zip: 3 qQ 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 perm it 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,inlall 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 our Notice of Commencement. � I —ch- Signature of Contractor-or-Owner Builder as applicable STATE OF FLORIDA COUNTY OF I Sworn to(or affir d)and subscribed befI2ge me of Physical Presence or Online Notarization thisaladay of I Name of person making stateme . Personally Known OR Produced Identification Type of Identification Produced i i ignature of _o``t��aryy Public-Stateo Florida) Commission NoZ'iTiV i'C't—Deal) BRITfNEYM.RICHMOND I ;. MY COMMISSION#HH 011993 EXPIRES:October 8,2021, so REVIEWS FRONT ZONING SUPE -PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev