HomeMy WebLinkAboutBuilding Permit Applicationi
All APPLICABLE IN O MUST BE COMPLET DR APPLICATION TO BE ACCEPTED
Date: Z 7 ZZ , Permit Number:
RECEIVED
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
FEB 0 7 2022
St Lucie County
Pormatino
Commercial Residential
-
CBDG Funding
PERMIT APPLICATION- FOR
000 -� wl- W.�—W
W
Address: 12� �JQj✓GI2P�%1� C-fN`l�� �o S i _ LUCIE
Property Tax ID #: qyLot No.
Site Plan Name:
Project Name
-0 v A--r Lit F'�- U %1 U—
New Electrical Meter Second Electrical Meter
(Affidavit required)
Additional work to be perforated under this permit - check all that apply:
�--Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof
Total Sq. Ft of Construction:
Cost of Construction:
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic
Block No.
Building Height:
Pond
Pitch -
—,tia-,,'„s•r�rsr.i' 4.•,a:.w`"- P .-_
EIDUMEN—- Es1a*t��a S 1c�a
k1 ...�,�.���'F', .zl>N xy...V r• ,f.�p.>;,9. �. �i F_::`� l,n.P=�.u.it�. w.. S ..�a. c'�:E � °"�:.r4->e.:a�ir:
y 'a'
S � - a`v.7�. g_ •a ..zr�'.''.G �'.,r.�.?,.i, ri �' 3 _
�OJ iyo
Address: 121 �� i��� LAJ
Company: `iN�-�' D[Ft` CDuf1
pp
City: 6Di 5T• j�UC-) State:
Zip Code: q Fax:
Phone No. 507, o (070 - LI5T* E-
.t�
Address: 15° ii'M -J' L
City: G'JNT74 6-da - State: :G�
Zip Code: �i�7i,�g�� Fax:
i7 Phone No /- SS- 02 -7
Mail: 6-r(a /dl' q0. C-0�
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 z5uu or more, a xtWKUty IMMILe U1 %.u'11 IC31�C11 . -.,.., 1-
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: - Not Applicable
Name:
Address:
City: -' ` State:
Zip:Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone: _
MORTGAGE COMPANY: — Not Applicable
Name:
Address:
City: State:
-Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work ana instaiiation as inalcaLea.
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 In 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.
o
Lucie County ansted on the lobsite before the first inspection. If you intend to obtain financing, consult
L I__ -I__ __ 1,f,,. rn nnrinb %A/nrle nr rPrhi-Hina vnur Notice of Commencement.
WILII ICIIUCI UI 9111 CILXLUIIIc vcIuIc Y-1..... ....... -- -- -
�SiignatureContractoVor - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF 3Ar- Lvz %c
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this day of 20aa.by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced tr Dom.
(Signature of Notary P blic- a
GNENS
DEANNA
�cf N p�blic • State of Florida
Commission No�� �rrijssian k HH 086359
M comm. ExPires Jan Z8, 2025
y
Bondedthrouq h National Notary Assn.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev 10112121