HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED rr,
Date\-%k\a/2k Permit Number:���"' d-
RECEIVED
NJvo L SULLY
FEB 2 8 2022
U15 ry9+ � elid-nt1nn St Lucie County
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
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Residential V
PERMIT APPLICATION FOR:
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Address: L4q 1"l �1�i �l� ��t ��k. {� C'.�
Property Tax ID #-t:-'�U1��'�
Site Plan Name:.1:no Q.n River EMdes Un&f geyerl
Project Name:
Lot No.
Block No.
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: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer —Septic
Building Height:
Name LLQXICGCa l (X
Name
Address: yQ1S M14ri)f, DrW6
Company;.::."
City:_ State: EL
Zip Code: 3y q39 Fax:
Phone No.. 77�?`-�Sa 2'y3a E-
Address'.,,;`." "
City: State:
Zip Code: Fax:
Phone No
Mail: SQ-iIEGO� [1Q + ER
ma;, I. C Om
IJ
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.
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 corLsideration 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 an'dSt,.Lucie:County_Amendmerits:
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 len r or an attorngy be re corrimericin ' work o,r recordin'g your.Notice of Commencement.
Signature of Owner/ Lessee/Co for as Agent for Owner
STATE OF FLORIDA
COUNTY OF 5Nr.
Sworn to (or affirmed) and subscribed before me of _Physical
Presence or Online Notarization
this/ c1,A day of 1-4-, 204A by
7A rCG e. 'S w C -,4v
-
_
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced JCL
(Signature of Notary Pu -State of Florida)
Commission No.
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pNNAGNENS
,�sR• aue�•• Public •State of Florida
•o�r� Notary }{H086359
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_'= ^�" <'•• Commission � 28
Comm. ExPfres Jan , 2025
Assn.
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'•'.?'oF h°r MY atonal Notary
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REVIEWS F ZONING SUPERVISOR
PLANS VEGETATION ;. SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW •• REVIEW 'REVIEW
DATE
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RECEIVED
DATE
COMPLETED