HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: I' —DL Permit Number: o��
RECEIVED
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[wilding Permit Application FEB 1 2021
Planning and Development Services St. L County
ermitting
Building anti Code Regulation Division Commercial Residential
2300 Virginiu Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: •.
Address:�/��_�Jt�-
Property Tax IU #: yv Z 60 ®Og13 Oe D S Lot No. O
Site Plan Name: _ Block No. Z 3
r Pro.iect Name: S_ L-l5_12g�7AG� E _P 4-
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New Electrical Meter Second Electrical Meter(Affidavit required)
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C :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: lam% Z _ Sq. Ft. of First Floor:
Cost of Construction: $ 5;?'d0 `— Utilities: _ Sewer _ Septic Building Height:
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Narne-_O"N 1664 G [-FU
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Name: e' 2id�: >
Address: •31 0 l3ewle- G72 rL d2�_
City: State: 4:f67
Company: 7&Z-3 LL
Address:
Zip Code: Fax:
City: lii0 5 f,Lcc« State: F�
.Phone No. E-
Zip Code: ? c/�E0 3 Fax:
Mail:_-
Phone No -7 77 2- Z Z`E 5F11 O _
Fill in fee simple Title Holder on next page (if different
E-Mail/Gp
from 'the Owner listed above)
0 if value of construction is 2500 or more, a RECORDED Notice of Commencement
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement
L
State or County License
is required.
is required.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City:
Zip: Phone
State
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name: _
Address:
City:
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 attorney before commencing.work or recording your Notice of Commencement.
�55
,
ignature of Contractor - or - Owner Buil r as applicable
STATE OF FLORID -
COUNTY OF
Sworn to (or affirm I) and subscribed before me of
Physical Presence or Online Notarization
this � day of 20 by
01. f5 ,,eTn hnm aV PZ
Name of person making statement.
Personally Known ORPro ed Id ntificatig
Type of Identi ' ation Produced _
(Signature bf Notary Pub State of orida) I . ~a ci -. "' P GG3008
Commission No. Seal�_?__w...,;.,
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DATE
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COMPLETED
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IU/12/21