HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: it z'022 Permit Number:
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Building 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: FiI 1-5cr2cc
L PROPOSED IMPROVEMENT LOCATION:
Address: _ 5yy P4U (t 0 Tt S l9.✓
Kx
Property Tax ID #: 3y/ U -SU 3 - U 2Y L/ - 600 - y Lot No.
Site Plan Name: _ l�1(3 le. r�.S Block No. I
Project Name: 64 131e-f ,,S
DETAILED DESCRIPTION OF WORK:
R.J'5 PC 4 C F_ U OK F� )-1;:v t Laic—' Z uJ 4t-P H.6'ree.A- C 4-&) DSO RM d P4 &fAf-i-U1004 fF
Pi91 N G2uct,.ro /,u N SC 4 FCU P✓G 2 Co�rvupr
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New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
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 _ Roof Pitch
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:
Cost of Construction: $ z 32S• H Utilities: —Sewer _ Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name DCA'S 134[3►cfCS
Name: TOrtN p4-Nrc24L
Address: _ -69 A4 40rO L�tN�
Company: FLIT 1�Lle— IC-
City: FT pi lit C t--" State: 1 %4-
Zip Code: 3VI 2- Fax:
Phone No. b(PI - E-
Address: t (0S 1 Sta, SOJTu k
City: poar F State: 'X:i-
Zip Code: 3VIkyJ Fax: 712. 3N4-3741L—
Phone No 71 Z- 3Nv - 3111
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail Pi5itm-t r ��lit�i-�'t`�FGf/l cL,cFNc� +VL C01
State or County License IBC 13606034
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:
DESIGNS
Name: _
Address:
City:
Zip:
GINEER: LC Not Applicable
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
State
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I Not Applicable
State:
X 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 or an attnrnav hofnrc rnmmon. i., vl. ,
----- - "•`••"•''�'�'1= VVUINU[ I CLUF _UJ[Jr, yuur Notice OT L Ornmencement.
Signature of C tractor - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF Sr l.0 c t G_
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this A- day of J FFNV 4-2 y . 20_Z_�by
304N P401141-tL
Name of person making statement.
Personally Known )— OR Produced Identification
Ty tification Produced
(Signature of Notary Public- State of Florida)
Commission No. _ HA 1(0 5/ 3 Y Seal ���`� ��e KONNI LENAE DEWITT
(Seal) �.. Notary Public - State of Florida
mac` Commission # HH 165134
My Comm. Expires Dec 10, 2025
Bonded through National Notary Assn.
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev 10112121.