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HomeMy WebLinkAboutBuilding Permit ApplicationI All. APPLICABLE INFO MUST BE COMPIL,4) FOR. APPLICATION TO B&ACCEPTED Date: Permit Number: r _� RECEIVED Q�mum- k Building Permit Application NOV 2 3 2021 Planning and Development Services St. Lucie County Building and Code Regulation Division CommerCial ResidenWifting 2300 Virginio.Avenue, Fort Pierce FL.34982 Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: Address: 2,fOd sly Property Tax. ID #: 2 Zz - J 31 0y U 1 ' - v Dd - 2 Lot No. Site Plan Name: C2 IZZ 3'-5_- 5, 2 D .5 k) 1 Block.No. Project dame; �95 ki, S'a /- S e_eP1P - L e,'s S q& DETAILED DESCRIPTION OF WORK: Ale 0 © Ids; U,G-J .'a 44 �.' �.� i2ls� Ie_ c�Ielo,�& -b y Ao_ e o4pi c'e- New Electrical Meter Second. Electrical Meter (Affidavit. required) CONSTRUCTION INFORMATION: . Additional work to be performed- under this permit- check,alI that apply: _Mechanical _ Gas Tank _ Gas Piping _Shutters _ Windows/Doors _ Pond _ Electric _ Plumbing_/ Sprinklers _ Generator- _ Roof Pitch. Total Sq..Ft of -.Construction: q 7J / Sq. Ft..of First.Floo/r. — •Cost,of Construction: $ l ��i° d �% A Utilities: _sewer /Septic -Building Height: aZ D OWNER/LESSEE: CONTRACTOR:; Name Name: e ©a e_ Or -F oc, Address: p9 Aled S'. � Company: B 09 'e-,9 r' Address: 5 & 01 J JU t e_ u 0 State:. �z/ City: �` r -e✓e- State: _� Zip Code: Fax: :Phone No. �`%% %oZf "E- Mail: vt f , e- oA Zip Code: 2 q��. Fax: Phone No �`? q 90 q % 3 Fill in fee simple fiftle. Holder on ne page (if different E-Mail C ^ 49 State or County License . (-' (9 0- % 1 3 6 O from the; Owner listed above) r It value of construction is 25o0 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: DESIGNER/ENGINEER: = Name: T 54cc-d1&k4_r' Not Applicable MORTGAGE COMPANY: _Not Applicable bw e. Name: Address: O 3 Address: City: a_ c' State: City: State: Zip: _Ja `o one 3� / �%� / 2 3 % Zip: Phone: FEE SIMPLETITLE HOLDER: _ Not Applicable BONDING CO ANY: Not Applicable Name: CIL, �y �1 a.ra R tLn & e-g- o! Name: Address: S. i 1-i. r Address: City: 'erc. e City: Zip: Phone: Z 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 comrnenced;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,.l,.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 commencine work or recnrdinP.vnur NntirP nf rnmmnnramant Sign r Owner/ Lessee/font actor -as Agent for Owner STA. OF FLORIDA COUNTY OF S T L 1A C. Swor to (oraffirmed) and subscribed before me of L-Physical Presence or Online Notarization this day of F%G¢D he C , 20-4 by Name of person makidl statement. Personally Known ✓ OR Produced Identification Tyw of Identification Prod- d (S nature of Notary, Publ - State of Florida) f C m/ mission No. 6 ` !S(�/ " (Seal) ti JONATHAN D REXFORD Notary Public • State of Florida _ Commission ; CC-948388 ,oF My Comm. Expires Apr 19, 2024 Bonded throcgi, tia"vai Nctary Assn. REVIEWS FRONT ZONING SUPERVISOR' PLANS VEGETATION SEATURTL"E MANGROVE COUNTER REVIEW REVIEW REVIEW .REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED