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HomeMy WebLinkAboutBuilding Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �� a� Permit Number: ' UD L�"'TW_ L_ Building pp 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: PROPOSED IMPROVEMENT LOCATION: Address: PropertyTax lD #: �S �— ��5 ' (�) )� S� Lot No. Site Plan Name: t� yen�-Yf- 0L'(+—aC-H oI-) C Block No. Project Name: �v n`arshco DETAILED DESCRIPTION OF WORK: New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additional work to be performed under this permit — check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters S (Affidavit required) Windows/Doors Electric _ Plumbing _ Sprinklers _ Generator _ Total Sq. Ft of Construction: of Sq. Ft. of First Floor: Cost of Construction: $1L400 O Utilities: _ Sewer _ Septic 01 Pond Roof Pitch 02 Building Height: r OWNER/LESSEE: CONTRACTOR: Name _1�i1ald Marshall Name: Address: [01Q� S ©Qean'Dr. lOA--h Company + 00. :s: City:yu risen -ExeOIC.h State: E3, Zip Code: 549G'l Fax: Phone No. E- Address: q&0 'Fi� df Su fi St City: Cc>coc1 State: Zip Code:?�2.92,1 Fax: Phone No -loi - 0Qa10 - q09 0 Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail L'flf i1COf1S�l'uC�'tOr1lAC iC,1Q1A n State or County License CG%C t5142.g1 If value of construction is 2500 or more, a RECORDED Notice of Commencement is requirea. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Name:Chris[DP11C-r Address: S2 y t.W Vi rA«1ia► _ Not Applicable Lieer5 Ave. MORTGAGE COMPANY: A Not Applicable Name: Address: City: Purl t Gard a Zip: 3BeG_ Phone gL4%-(p2Ss-CxQ3S State: T"L City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Address: Y- Not Applicable BONDING COMPANY: Not Applicable Name: 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. 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 attornev before commencing work or recording your Notice of Commencement. /ignature of Contractor - or - Owner Builder as applicable STATE OF FLORIDA COUNTY OFAA(arf) Y) Sworn t5(or affirmed) and subscribed before me of Physical Presence or Online Notarization this 2_7 day of ^5PUnu0or4 2022—by Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced (Signature of Notary P blic- State of Florida) �t KENYA AVELLANEDA Commission No. IAH 11SQ-1`7 (Seal)^Notary Public State of Florida •�ni`'•� _ Commission # HH 119077 W`•t'�};o-°c My Commission Expires April 19, 2025 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 10/12/21