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HomeMy WebLinkAboutBuilding Permit Applicationr All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ��� Permit Number.�),a d RECENED R 9gad Wllon3 'i8 JAN 1 4' 2022 JAVA UPC Building Perm itt 'atiorbt.Luc_ d Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial CBDG Funding Residential PERMIT APPLICATION FOR: x.<s'a v..:::42 L;= � -- a:, n �E4 ti h � ;"tr ��e,.r 'd`3,k -.. t',5 ti%•ru,a..'r� a r1c���!��3 Cr "�i1i aWW 1-N Li�r.r�') [!c/�IIY�t�'�p�•s,'r��'+ -�r'� a `�aw.�'+`'Y,'-�-` '"-'�.i� tea` 14� �.i� t•Tc .� �•`� k:'�$ �� 'S'.�vsz=i 4 Address: L171 Woockrrst�r F! tNrc-t- FL 3411 LCS7 Property Tax I D #: 23b g - .SG 1- a© 11- 600 ^ Cf Lot No. Site Plan Name: Project Name: l-V61V(A ^ 41c jc_ Block No. 10e-1`c�1.te3 e4tgE 'Fr,f' SArt E�:$e, of e4yA'j2 j2Ce_� W A%P, ce&%Cm4-e_ tCt 0(!!A C,-- Nc,46 s1QC_ 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/D,00rs Pond _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch ��� ` Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ _50,W0 Utilities: —Sewer —Sep tic Building Height: 14 •r't :..� i -e ,, -wry.' x`.j.�# �,r' -^i`' , •2 -€ �R.•.�,a-"w`'+ �x,,�..x- s!{ t• c3`+. S.3'�i�.���, s'3k. ..,.. t'2 F.,s�e,, u .u� �fj •'15� of .�-.i.3�' r�—.. n �,i. Name \01i cw. ZyS6- Na,me% .. _ Address: 1-111 QWC)CIr33- Dr' =Company: a' City: Zip Code: 34VI S Fax: Phone No. 7 State: 4- Address-,: CO. Zip Code: Phone No State: Fax: Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail State or County License _ 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. p f ,o .P i S32 5� - $" � 'i`' y 7 � '4�'� �F�N/kr "w 'M F'i.4^ ` � �. i ���� �• MORTGAGE COMPANY: M . * ...3,t .%F�; .�a3��+'r _ Not Applicable DESIGNER/ENGINEERi•:",;_4,; Not Applicable Name: Name: Address: Address: City:State: City: State: Zip: .:Rhone "i 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 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 Xnrith lonrlpr Ar ;r, attnrncv�PfnrP rnmmPnCing wnrk or recording your Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTYOF Sworn to (or affirmed) and subscribed before me of _ Physical Presence or Online Notarization this VA day of Zq— 2i:fJa by Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced (Signature of Notary Public- State of Florida) Commission No�-k *.A."5 .ti'aY'6uB-., DEANNA GIVENS Notary Public • State of ;*orica P` Commission # HH 086359 oFr,,.•°' My Comm. Expires Jan 28, 2025 Nationalled through Assn. REVIEWS FRONT P A S VEGETATION SEATURTLE MANGROVE ONING SUPER ISOR COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5/2U/23-