No preview available
HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 1-13-22All APPLICABLE INFO MUST BE COMP& rid FOR APPLICATION TO BE ACCEPTED f Dater �. Permit Number: L RECEIVED o� rl JAN 3 2022 Building Permit Application St. Lucie County p mitting Planning and Development Services Building and Code Regulation Division Commercial _ 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding PERMIT APPLICATION FOR: Address: er Residential Property Tax ID #: —CO3 el OCO —0 Lot N4,�37 Site Plan Name: /%7�_-/�� �Ll/� D�/%�G-" Block No. Project Name: Z42fi7 i�"6 r 6 'r�,o /7tr %,,9-C �l CA/_%G— New Electrical Meter Second Electrical Meter (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: 00 'L Sq. Ft. of First Floor: Cost of Construction- $ cV, �7�' aT Utilities: _ Sewer _ Septic Building Height: ' �[�+a,�;� 1!�5�"F c' ^r S .....i.. �. -+.� ... a ..n-.. ..i....o.. .; ..a 3y...e. . S f ssr .- Name Q'7 /� �%�� Name: Address,:: l Company: City: )-f/ /ef " State.i_� Address: City: State: Zip Code,-3�9 Fax: Phone No. c�S��oZD�.��o�?� E- Zip Code: Fax:. Phone No Mail: / oo Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more, a RECORDED Notice of commencement is requirea. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. ggn rt �'3A3 Cda' 1 i �" i« _c � .. ...st::i�...1,...." DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as Indicated. I certify that no work'or installation has commenced prior to the issuance of a permit. St. Lucie County makes no rep resentation. is-granting4-p.ermit�will� authorizkhe.permit°hp.lde�..to:4uiId the subject structure which conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict ar pr©hibit such structure. Please consult with your Homeowners Association and review.you,r deed forany restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will, in ald respects, perform the work in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from, undefgoing:efuN,congurxency..rev(e.y ,%.r.00rn-additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for. improvements to your property. A Notice of Commencement must be recorded in the public records of St. Lucie County and posted on the jcrB�jth,b0ore_t-he fir$t,.nspedtQn.rlf�you :intend to obtainjir>:ar�cing, consult k f,-..,, r.- nnrino %Alnrie nr rarnrriina vnur Notice of Commencement. WILII ICIIUCI UI CII.I QLLUI I lc ,4/c!v! t_ 1. 1;111a. J"' .......... ___. _.... _ _. i Signature f Contra - or - wner Builder as app (cable STATE OF FLORIDAS4 � )'A , vl / P COUNTY OF . Sw.or to (or affir and subscribed before me of 2""QL.by Physical Presence or Online Notarization this day of Name of person rAaking statement. Personally Known OR Rwuc,ecl Iden ' ication Type of I ntification Produced (Signature of Nota ub ic- State of Florida) V--- -" - u r �PSYPu P ,Go'• AUDREY B. HUMPHREY Commission No. (Seal) `: ° MY COMMISSION#GG300817 = EXPIRES: March 6, 2023 .; F t � [bonded Thru Notary Public Underwriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 10/12/21