HomeMy WebLinkAboutBUILDING PERMIT . l
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: , 17, Permit Number: 0�vz�3'aNIS
c�� (� RECEIVED
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JAN ® 7 2022
° ~" Buildin PermitA licati®r1 St.Lucie County
Application Permitting
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding
PERMIT APPLICATION FOR: S
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Address: 2ZO "Y -4- � Ec_r,- 4�'S Lua l R 'rc..c 14Z
Property Tax ID,#:n., \yam_ 3t1 e.d - ria1U1 -W 6 - 3 1 Lot No. /
Site Plan Name: ;v '?L pal orb �i. 0 C � (� (,iU t �/ Block No.
Project Name:
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/J�us <__Ci_)S -d-!r?e ';V.(_) . S-'I-5-L rc"Mr (ter C"A C
New Electrical Meter Second Electrical Meter. (Affidavit required)
Wes. "- �
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Additional work to be performed under this permit-check all that apply:
✓_Mechanical _Gas Tank _Gas Piping —Shutters �f/Vindows/Doors _Pond
_vElectric Plumbing _Sprinklers _Generator v'Ftoof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: $ y 1 dd0 .'30 Utilities: _Sewer _ eptic Building Height:
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Name G Marne
Address: 2 O6 L ,c �c (ci(� Company.a
City: -c. e-e_a State: Address: 27sDC �e�r�iC PGcL RC1c`/
Zip Code: :S �r�/�i Fax: City: a- i2z!G. State
Phone No. E- Zip Code: ' ' Fax:
Mail: o) 6 iAdc-rjk4 nv)"l Phone No
Fill in fee simple Title Holder on next page (if different E-MailCIG,/�/l
from the Owner listed above) 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.
e,W- N
t # fAAM �
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY:. _ of Applicable
Name: 11JrI116L ./-ry jq Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable
Name: fot:.<,A4 -Iqgel/ 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 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.
Signature of Owner Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF 5
Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization
this 1 day of -Z5q'r-N 200% by
C4"S"
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced
(Signature of Notary ublic-
iY P�'• DEANNA GIVENS
Notary Public-State of Florida
Commission No. Commission#HH 086359
My Comm.Expires Jan 28.2025
Bonded through National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev5/20/21