HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 112Z I Z2 Permit Number: aa�1'°dal
L�lC RECEIVED
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� wJAN 2 6 2022
PUP :� ° K4 Building Permit Application
St,Lucie County
Planning and Development Services Permitting
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: ,mom
PROPOSED I(UIPROVEMENT"tlLOCATI.ON. r ; u,
Address: 131 SE 1 WQQEQ '0 C I X9 d� �
Property Tax ID#:341 -Q1 — 24)— Lot No. ZZII
Site Plan Name: Block No. `t
Project Name:
I��TAILED DE�S��RIPTION rOF WORK:.
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e V�,�]�� I •IS-ire 1
1 1 `�1 � V�. 1 p e"cJ� v �f..� •ey Aumey')--fi 2i) r1
00 LtC�1 SV 0 Y\Y-D P Y D QV—A Y)CN
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION IN' FORMATION
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 k Roof 2 2 Pitch
Total Sq. Ft of Construction: IL.P 30 Sq. Ft. of First Floor:
Cost of Construction:$ , Zl0 00 Utilities: —Sewer _Septic Building Height: 1
IO WNER/LESSEE ,CONTRACTONR::
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Name e-1 3 CLyck Oa
..SI a Name--j
Address: 13 E I S LuCQ Y \0%� Company: � l (
City: ���� S�. uUIc-lQ1 State: L Address: 41( 0g5ESDlel�p -
Zip Code: 5qC)83 Fax: �W.n City: CAI a Y+ State:IPL
Phone No, ( - 2-1 (�552- E- Zip Code:Cl q7 Fax:
Mail:ds, ��al l )�� C �Z.. �M Phone No� -`.P-1 g
Fill in fee simple Title Hol er on next page(if different E-Mail n ow LW
from the Owner listed above) 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.
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SUPPLEMENTAL CONSTftUCTLON LIEN LA'W INFORMATION h.
R, �o
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _)K_ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: 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.
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 attgrney before commencing work or recording our Notice of Commencement.
Signature of 76actor-or-Owner Builder as applicable
STATE OF'FLORIQACT1�
COUNTY OF 1`�J�
Sworn to(or affirmed)and subscribed before me of XPhysical Presence or Online Notarization
this?_Z day ofJ 20y
II
Name of person making statement.
Personally Known "� OR Produced Identification
Type of Ident'fication Produced
(Signature f o ary Public-State of Florida)
MEGAN LAWRENCE
Commission No. Notary Public-State of Florida
Commission'HH 9 0458
My Comm Expires Apr24,2025
3onaec through Natioral Notary Assn.
REVIEWS ;FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
RECEIVED
DATE
COMPLETED
ev 10/12/21