HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -.10V
Permit Number:
RECEIVED
Building Permit Application JAN 2 5 2021 Planning and Development Services St. Lucie CountyPermitting
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: _5-rew_ P ki-les_5
PROPOSED -IMPROVEMENT LOCATION:
Address: b�e-T /yip A. c e
Property Tax ID #: _ ��6 ? �- 70,2, -a IgO
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
2K rva�' Pea®r.-e �il�•rAds a4l Fti4V�11 1/) /y0 m•fe• we f-cie/ /L01074
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
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 Y_ Roof Pitch
Total Sq. Ft of Construction: .3�2_ S Sq. Ft. of First Floor:
Cost of Construction: $ Y, 00d Utilities: _ Sewer Septic Building Height: / aL Y
OWNER/LESSEE: CONTRACTOR:
Name_ Name: UQ C. Kxo j
Address:_ j`oGo l'At 4 reyceA Company: C-rlc�li�rLl PrOtO - gQ ri )Ii Las
City: crr State: F1 Address:_ 65219 L� IIli
COI
Zip Code: _3y f g ! Fax: City: tRiu roitw State: (--I
Phone No. 7 7 2 .9-° 1 gq Zip Code: Fax: *9 13- 3q 6- OI I I
E-Mail: Phone No 13—j-I a 3 - 3c4 V3
Fill in fee simple Title Holder on next page (if different E-Mail GOB+�G+,o_a a �-�' (ori �Ia -Cary,
from the Owner listed above) State or County License RQHr o..
If value of rnnctrurtinn ie 7Snn o% w.Z___ _r .. _ __ _
.,.....,1 a n16��nL#r.L# 1VW1,1Ce yr %.vmmencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of commencement is required.
SUPP'LEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER ENGINEER:
/ Not Applicable
MORTGAGE COMPANY: V_ Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip' Phone
city: —State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: y,' Not Applicable
BONDING COMPANY: v, 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 is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners 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
7
with lender or an attorney before commencing work or recording your Notice of Commencement.
re of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF IA i (I %bprp ug13
Sworn to (or affirmed) and subscribed before me of
this 1 dayof—ILIILI 20Dj by
Name of person making
IN
ment.
Personally Known OR Produced Identification
Type of Identification Produced
(Signature of Notary Public- State of Florida )
Commission No. GG 1345017 (Seal)
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Physical Presence or Online Notarization
WILNELIABADILLO
o�rgYAUBIi
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Commission # GO 134507
N9,
Expires August 14, 2021
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FOFr�°Q
BondedThruBudget Notary Services
SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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