HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR. APPLICATION TO BE ACCEPTED
Dater: d b 2>7Z2 B Permit Number:
lip-4541 '
°` `` �-`"` Building Permit Application
Planning and Development Services
Building and Code Regulation Division Ornmerclal' Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 )
PERMIT APPLICATION FOR:
PROPOSED iMPROVEIVIENT LOCATIOI�ri ;>
Address: LJLJ Le- Vl 1\C, W
Property Tax ID #: ) 6D0 i 0 0 O S
Site Plan Name:
Project Name: � JiiO � S; aaviuej
DETAILED. DESCRIPTIO
New Electrical Meter Second Electrieal'Meter (Affidavit required)
CONSTRUCTION INFORMATIO,'
Additional work to be performed under this permit- check all that apply:
Mechanical _Gas Tank _GajPiping
_Electric _Plumbing _Sprnklers
Total Sq. Ft of Construction:
Cost of Construction: $ 'a J 00.0' U
_Shutters _ Windows/Doors _ Pond
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
tilities: _Sewer _Septic Building Height:
City: (�Vy"tx R.- State: (7-(
Zip Code: Fax:_
Phone No. q;�2 -y61; - 9P53 E
F-Mil• 4
Fill in fee simple Title Holder on next page ( if Different
from the Owner listed above) 1
4
Company: FIPda}�P✓S¢��rnc•dlb�A�tL�
Address: 6 r 11
City: fdif 4- Lv Lc; e State: r-L-
ZipCode: 3`{�ii Fax: +,)-4-1, 1t^31
Phone No 21-11-y61,1311
E-Mail h1"%t��ere 9"-AC-A Rc�+r-AC-'
State or County License Ci'aC0569,� -, �
If value of construction is 2500 or more, a RECORDEQ 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 Ap
icable
'°a ,.
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State
City: State:
Zip: Phone_
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Ap
Iicable
BANDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
UwNtK/ LUN I KACTOK 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 �rior 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 is in conflict with any applicable Home Owner ssociation rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners As ociation and review your deed for any restrictions which may apply.
In consideration of the granting of this requested pe -nit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida B ilding Codes and St. Lucie County Amendments.
The following building permit applications are exem from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, 'igns, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Recor :a Notice of Commencement may result in paying twice for
improvements to your property. A Noti �of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite Ilefore the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording your Notice of Commencement
Sign ture of Owner/ Lessee/Contractor as Agent foul-o—w%er
STATE OF FLORIDA '�-
COUNTY OF
Sworn to (or affirmed) and subscribed before me oft . __e:�'Physical Presence or Online Notarization
this .sue day of _ 3c4v%-c-.,,,. , 202k by
Name of person making statement.
Personally Known -/ OR Produced Identificatton
Typiff'of Identification Produced I
I�Rnature of Notary Public- State of Florida )
Commission No. H 11ei0e 9
(Seal) f
t;
REVIEWS FRONT ZONING SUOERVISOR PLANS
COUNTER REVIEW REVIEW REVIEW
DATE •
RECEIVED f
DATE
COMPLETED
JESSICA GROVER
Notary Public -State of Florida
Commission # HH 119064
My Commission Expires
April 19, 2025
VEGETATION SEA TURTLE I MANGROVE
REVIEW REVIEW I REVIEW