HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED y•
Dater .. • .u'd��4 Permit Number: 0•3 ` ID, v
;. 0llE ,` - RECEIVED
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Building Permit Application MAR 0 8 2022
Planning and Development Services St-Lucie Cou
Building and Code Regulation Division Commercial ReSidentiaTermi
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-15.78 CBDG Funding
PERMIT APPLICATION FOR: .Nvi-c, Loi fc"(
P' CJPOSED IMPROVEMENT LOCA 4
Address:
Property Tax ID#: �� • /'Y" O��' Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
LA L UV Q
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION I'NEORM TION:
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: $��('Z�� Utilities: _Sewer _Septic Building Height:
OWNERf LESSE; CONTRAC OR:
Name !✓rlo1 Glfe_— l Name: v _
Address: S�OLo � n���Y Company: t
City: F �� State: Address: V
Zip Coder 7- -Q 7 Fax: City: 7-1 Fit�y[ ,. State:
Phone No. E- Zip Code: SLIq 1�iL Fax:
Mail: Phone No Z1t54SZ ZgC,,c9
Fill in fee simple Title Holder on next page(if different E-Mail CS t-f) H_ a i( !?UiM -ca-1
from the Owner listed above) State or County LicenseAf )SCiZI06
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.
5 FP EME�N AL C�ONSTR CTIO EN LAW N OR ATIU
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 consullt 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 our Notice of Commencement.
TP <c �
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIQA
COUNTY OF S} LLALt:%0
Sworn to(or affirmed)and subscribed before me of v"'P`hysical Presence or Online Notarization
this 'J6 day of MO—V c Je\ 2023_by
Name of person making statement.
Pers Wally Known�/ OR Produced Identification
Typ f Identific Produced
Signature o r Nof ry Public-State of rorid4, \``� PVB��,�%
Commission No. (Seal);`��� 011612025
N Lauren
Marie Scott.Q
n 4`
9 H 186875
REVIEWS FRONT ZONIN& .-^ SUPERVIS(Wo PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW �♦p3/I��\1� REVIEW REVIEW REVIEW REVIEW
DATE "
RECEIVED
DATE
COMPLETED
ev 5/20/2