HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 011 01;2Q2a Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fart Pierre FL 94993
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION: I
r_+ - t, &_ k;
J
Address: 7 CCc i 0� �(95l -.-
Property Tax ID #: I - - - Lot No._.�
Site Plan Name: r1C• LA yv� } -1 Block No.
Project Name: _ ALA e_t \AecA e cA
DETAILED DESCRIPTION OF WORK:
t71no V Yvn. i
New Electrical Meter 1y A 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
Electric �_ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 2'7i;JV.(::)o —
OWNER/LESSEE:
Name
- --
Add
City,
Zip
Pho
Mai
Sq. Ft. of First Floor:
Windows/Doors — Pond
Roof Pitch
Utilities: _ Sewer _ Septic Building Height:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name:
Co m pa ny:I
Address: —
City: State: �.
Zip Code: L Fax: C
Phone No :2- �_—
E-MaLK CM
State or County License_ 6d 815 max
R
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:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
_ Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
!Name:
Address:
Citv:
Zip: Phone:
Not Applicable
State:
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 oran attorr��efore commencingt.
work or recording your Notice of Commencemen
Signature of ontrac r - or - Owner Builder as applicable
STATE OF FLORIDA,
COUNTY OF } L
sworn to (or affirm d) and subscribed before me of Y Physical Presence or online Notarization
this ilu day of (1,
. 2022 by
d J "1'4 aff1 _
Name of person making
statement.
Personally Known ✓ OR Produced Identification
Type of Identification Produced
(sin f r P t o I ri a)
;� "G JULIE JANE MCCAULEY
Com __Notary Public • State 0¢ki*
Commission 0 HH 49824
arr` My Comm. Expires Oct t, 2OZ4
Bonded through Nationat Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE
COUNTER REVIEW__ REVIEW REVIEW REVIEW REVIEW
IX —-
RECEIVED � _ __ ___.- �..----•- --�
_._._...---....-
COMPLETED -
MANGROVE
REVIEW
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