HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICAB INFO `MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
- D"ate;� r� Permit Number:
Planning and Development Services
a� na.o�aoi.
RECEIVED
FEB 2 4 a22
Buildin Permit � lication
St..Lucie tt n9nty
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
ermi
Residential _\ r
Address: 55C) A O LIA F3-=.341003
Property Tax ID #: ���� " S� J "'1D" O (� - - Lot No. (�O
Site Plan Name: Q1V �i QQr� \1�1� (o Block No. St -
Project Name:
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit- check all that apply:
(Affidavit required)
_Mechanical _ Gas Tank —Gas Piping _ Shutters -Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers Generator Roof A/]—? -- Pitch
Total Sq. Ft of Construction: �' Sq. Ft. of First Floor:
Cost of Construction: $ ?-% %-00 Utilities: _ Sewer _Septic Building Height:
Name C O"Oi"C -b ft
Address: 550 51&3 A CAA Uvd
City: State:
Zip Code:�l�_ Fax:
Phone No. 3SO- �M- 9AL
E-Mail:
Fill in fee simple Title bolder on next page (if different
from the Owner listed above)
Name: t& r iUNIX(SN
Company:
Address: 3S22D 1W A -��n1_ & _.
City: Pam f *V Stater
Zip Code:�34'CRC� Fax:
Phone No 7_ 2I -I-MW
E-Mail StP kM+YQ E� mU ` uyy\
State or County License CU32_691V3
If value of construction is 2500 or more, a RECORDED Notice oT commencement is requ,reu.
If value of HAVC is $7,500 or more, a RECORDED Notice of CommencWment is required.
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OWNER/ CONTRACTOR AFFIDVIT: Application is hereby mace to ootain a perms. w uU uic WUl N ails — -- --
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
structturin e. Pleasle consult withpyour Home OwnOwners
rs A sociation land review your deed fora
nyrestrf tons which may ct or
prohibit such
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 Count posted on the jobsite before.the first inspection. If you intend to obtain financing, consult
with le r or-ffney-lae Dre commencing work or recording your Notice of Commencement.
to ner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF M fbO
Sworn to (or affirmed) and subscribed before me of
this 1%day of 2021 by
Name of person making statement.
Personally Known 11 OR Produced Identification
Type of Identification Produced
(Signature of Notary PubTic- State �Inrida )
Commission No.11-IH0n553i (Seal)
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Notary Public State of Florida
Melissa HrubyMy Commission HH 075534
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