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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 2--/`f- Zd ZZ Permit Number:PP 0--2 . OSS�. ( � T, 6uiuiwJ8d I�� ` ' 4unoo aion-y.1S O i 83J Building Permit Application Planning and Development Services a3A13�3l� 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: RL 3 J fu G Ys U PROP SED tN1 'RC1IIEMENT .0d T(? 51T,u ° 4 ��1,412 ?,in�'M1r 1111 Address:-- ! P1IVC C`/� der S/- 1ec/c_ 3�9rZ Property Tax ID#: 7 Z — 70,3 -- 003 000 Lot No. ZO Site Plan Name: Block No. Project Name: tlt 'il:`AILED'DESCitPl'1 �I Y'?� � VY;.O lun `a (4j�i4�i��e w C7vi tiu}SkF t! ,, Xr f4'CSi�t/f�'�"t'a!4 a vfX'. S'` Ptw Welt��a E' Y S �J° 1 �, l� 7 a` W (TU (; ©CI.S 1eE A xJ 977-/ Pt YZ New Electrical Meter Second Electrical Meter (Affidavit required) ' MRNSTRU Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Pond _Electric numbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ �Q l7©, ' Utilities: _Sewer _Septic Building Height: OWNER :tESSy#4 � htf5w � h {•fy \�}} 1ARfd�1 w R d>+ 3 {yM1 l t�?C1GI R 4 F. S 'saVIVO s Name Name: NT4aa /[ L-710 . Company:0,1AC. f i V C.it 44 91,LiG State: Address: P6 . bgrx iY" Zip Code: 3Y9,1-Z- Fax: City: -pU�e-T SW«yt,✓U 4F State:/C(_ Phone No. 77Z e) 'I E- Zip Code: Z Fax: Mail: Phone No 772 - ZZU 7S_ 7-7 Fill in fee simple Title Holder on next page(if different E-Mail_ A FrJ 02 from the Owner listed above) State or County License CFL /y3 U 2 RV If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. if value of kAVC is$1,506 or more,a kd6itDEO Notice of Commencement is required. g7A,'ik� —�1�'�'i� ";....c �� �ttfd r :.l',.' ., '4 •u �ro}s, } ,f.,; 1 P .Y 1, S4 r;X Y'nr IL�+. H(l�r1h'tl `+t n-aa G:ONSTR CT1f3N� ,li't4�!' LAWINF�RMA�1E7, yr . ax.Efn.(x�..t •, �`.,•�.. �i• +c `'�� , +r4 ta` - r rtxi'a^Si`,r; ,�• .$ ,R:. .t'�s��.. M ..Y'.ww-2`.;Sifl..+.f\...,_d sy,� 4, ,�`h1�;, <:� '�4 ,�.E,.xa �� .,�.. :-r, ::r:r� Ms.9. ,�. .. . . 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 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 i 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 Owner/Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF Sworn to(or affirme and subscribed before me of Physical Presence or Online Notarization I this day of 2(0,) by Name of person maki g statement. -=— / AUDREY B.HU�4PHREY ;P 0'." Personally Known OR Pro Identifi tion P O MY COMMISSION#GG 300817 t" t EXPIRES:March 6,2023 Type of Identification Produced— ,N• =�= Banded Public n— de���w:J>� (Signature of No ary blic-State of Florida) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev 5/20/21