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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number. © xU lz CI , v RECEIVED Building Permit Application JAN 91 2022 Planning and Development Services SSS..Lyycie Cou�nty Building and Code Regulation Division Commercial Resider 'AcmeiNittg 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding PERMIT APPLICATION FOR: D Ifs 0 I N Address: '7y0,S_ S13 NTY-4 C 1613,(3 Q LU D Property Tax ID It: _BD17 6d-7- ooL46- 006—L( Lot No. I. A _ Site Plan Name: Block No. 71 7— Project Name: % - ARK; wo1 c 1 1. of loss " l S A vyl e ,o t 11 iv) n 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 I/Roof (1/ Pitch Total Sq. Ft of Construction: 2Jo .S ts?1-f Sq. Ft.of First Floor: t3 00 Cost of Construction: $ i-700 Utilities: _Sewer ptic Building Height: tl_1 IL WARM 3' Name i Qt use MCG1h+h l cy') Name:-<ncc c_ �-J kill e7 Address: -]4D S 50,64-�q d a vow Slua Company: O 4e C.k 12c'n 0 Pi Q L L� City:-fM'f4�6'EC[� State: Address: I?,7_n 2_I.s� �V� SU� Zip Code: Fax: City: U`eV© b*2Gl qState: Phone No. ]M- S l GU7 E- Zip Code:_ 3��(G,2 Fax: Mail: Phone No 172- W4 S -7/.sfo/.s Fill in fee simple Title Holder on next page(if different E-Mail' O -e C k from the Owner listed above) State or County License 00 �s. 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. IT UWAFATirre 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. 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 au applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such structure. Please consu t 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 attorney before commencing work or recording our Notice of Commencement. Signature of Contra r-or-Owner Builder as applicable STATE OF FLORIDA COUNTY OF , 1� Sw to or affir d)an subscribed befor me of Physical Presence or Online Notarization this 1 day of 20y `e- 0 Name of person making statement. / Personally Known OR Produc ntif'cation Type of Identificati Prod ed L (Signature of Notary ublic-State of Florida) yP�,, KAREN S. NIELSEN Commission No. Seal _ e State of Florida Notary Public (Sea[) -. �_ Commission # GG 207484 01�,___ ;� My commission Expires�°�` June 12, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW- REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev