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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ` Date: � Permit Number: IL ��� ' RECEIVED WWI 0 , Building Permit'Application OCT 0.4 2021 Planning and Development Services Btu LuGie Eot�nty Building and Code Regulation Division Commercial Residential QiR,i I Ig 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding Address: Property Tax ID #: I Lot No. —I Site Plan Name: P0Al Y � Block No. A Project Name: 1i of,' K Shoe /SI1E� New Electrical MeterSecond Electrical Meter 10 (Affidavit required) C�NSTRl1 TION .NTIMINSH 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: _Do �4 . Cost of Construction: $ (7500 e DO Sq. Ft. of First Floor: Utilities: ✓ Sewer _ Septic Building Height: OWNER/LE-�SSE�: CQNTRACT©R: Name Ri1�/�/V��il] Name: Address: �yc/Q J ClVAKS / A fE_ lQ.t/F City: AP-4 SL State:/ Zip Code: Jymi-',� Fax: Phone No. &7a2 ) 3-�Q- 5.3a1 E- Company: Address: City: State: Zip Code: Fax: Phone No Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail State or County License 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. 0. DESIGNER/ENGINEER: Name: _ Address: City: _ Zip: Phone FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone: V Not Applicable MORTGAGE COMPANY: Not Applicable Name: Address: State V Not Applicable City: State: Zip: Phone: BONDING COMPANY: V Not Applicable Name: _ Address: City: Zip: Phone: 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 withAender or an attorney before commencing work or recording your Notice of Commencement. "4Sign vetoMcaner = essee C-ontractor as�ARerTtfor� wtaer STATE OF FLORIDA COUNTY OF S.3e LJeWt4k Sworn to (or affirmed and subscribed before me of _ Physical Presence or Online Notarization this � day of �� 20aLl by Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced 1.-D L rida (Signature of Notary�Wm DEANNA GIVENS Commission NoN%�ry Public State of FloridaCommission X HH 08635 Expires Jan 28, 2025through Comm. National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5/20/21