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HomeMy WebLinkAboutBuilding Permit Application CorrectedAll APPLICABLE INFO M ST BE C Date: / av 'Tu, It � �CC�L]L Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Address: Site Plan Name: Project Name: Pe OCT 12 2021 EMCIA1 Commercial CBDG Funding ,r: O2 /07— / in �- _ DETAILED DESCRIPTION OF WORK: ------------ New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Block No. Additi nal work to be performed under this permit — check all that apply: Zechanical _ Gas Tank ^ Gas Piping _ Shutters _ Windows/Doors _ Pond klectric Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction^ Sq. Ft. of First Floor: 5c/"�0 r Cost of Construction; $ /,5, ODe� Utilities: _ Sewer N-ep' tic Building Height: , OWNS LESSEE: CONTRACTOR: Name 16 u. rr Name: e i pj Address: Company City: State: _ Address: �lp© Zip,Code: Ce Fax: City: State: Phone No. E- Zip Code: ( Fax: 77 Mail: Phone No Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or County License •• --••-- •-• --••... w...-.• •. �..••.......I.,I W, a nca.vnur•r wvuce ur %.vmmencementis requirea. If ­ of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN SLAW 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: _.Not Applicable Name: Address: City: Zip: Phone: BONDING COMPANY: _Not Applicable Name: _ Address: City: _ Zip: Phone: UWNtK/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. 1 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 wnrk nr rPrnrriina vnt it KIntira of re%mman,.rn, n+ Signature of Owner/ Lessee/Contractor as,Agent for Owner Notary Public State of Florida e N N Mims Amts �1 t� My C�,ommi"ion GG 913313 STATE OF FLORID / @a �lr"091f6/2023 COUNTY OF , -�— , e�p Swor (or affirme n s scribed before me of Physical Presence or Online Notarization this _[J day of 20,21- by Name of person making statement. 1`?,Tlam, g �. ,, Personally Known OR Pr dentification r; Twzagff Identification Produced f OT 12 2021 (Signaturb of Nota blic- State of Florida) r.•. BY: Commission No Notary P((,�>s Of Rvide Ahims Armstrong co My Commission GG 9i=3 of Expires 09/16/2023 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED o., 1-3111-1-1 ....v .�, cv,