HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 02/08/2022 TUB,12e01 FAX 772 3367566 AC Advantage; ina. �001/003
All APPLICABLE INFO MUST AE COMPLETED I:QFLAPPLICATION TO BE ACCEPTED
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Building Permit Application St,Lucie County
Planning and Development Services, Permitting
Building and Code Regulotion Division Commercial Residential
2300 Vlrginla Avenue,Fort Pierce FL 34982
Phone:,(772)462-1553 Fax; (772)462-1578 CBDG Funding
PERMIT APPLICATION FOR: _ VA A
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Address:
Property Tax ID#: Lot No
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Site Pfan Name`: - Block No.
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New Electrical Meter Second Electrical Meter (Affidavit required)
.8 MIN W,111
Additional work to be performed under this permit-check all that apply:
L/Imechanical _Gas Tank _,Gas Piping Shutters _Windows/floors _Pond
,. " . Electric __Rlurbing sprinklers _Generator _Roof Pitch
Total 5q. Ft of:Construction - 5q F.t,of First Floor:-77
Cost of Construction:$ Sr 'S Q Utilities: , Sewer Septic Building Height:
Name Name:
Address:V�R(06 Q�t Y�() Company: \/
City___V} >rC State: =-Address:—_1—C12.
Zip Code.• 'S� Fax: _City: QJ-Q— - State: -- --
Phone No. E- Zip Code: Fax:
Mail:__ Phone No—Y11L-,�3G—CaG Co
Fill in fee simple Title Holder on next page(if different E-Mail -66- e C-Lc�\IQA LK C
from the Owner listed above) State or County License
If value of constructlon is 2500 or more,a RECORDED Notice of commencement Is required.,
If:galue of HAVC is$7,500 or more;:a.RECORDED'Notice"of Commencement is required.
02/08/2022 TUE 12: 01 FAX 772 3367566 AC Advantage, ine. U002/003
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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 fo.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 grantin 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 w applicable
your Homeowners Assoclatlon 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 Comrrience'rtient may result in paying twice•for
improvements to your property. A Notice of Commencement must be recorded in the public records of 5t.
Lucie County and posted on the jobsite before the first inspection, If you intend to obtain financing,consult
with le der or an attorney before commencing work or recording our Notice of Commencement.
SLKature of Contractor-or-Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF
Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization
this S day of Te_�b 262.�_by
G � V.�I,
Name of person making statement,
Personally Known D�0 roduced Identification
Type of Identification Produ ed
(5i atur of Notary Public-State of Florida)
� ��3 �J(seal) Jamle PernaCommission No, NOTARY PUBLIC. .
STATE OF FLORIDA
Comm#GG267323__
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