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HomeMy WebLinkAboutBuilding Permit Application i i All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTZD Date: Permit Number: �o LL RECEWD MAR 3 'T"` Building Permit Application 2022 0 D Planning and Development Services St.,Lucie Co P. mi ' 9 Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding i PERMIT APPLICATION FOR: a,xs. cis a s e x'sx a„3 r xxx:.�`.�.8ek�C�.% �xpi[:x...x 9sII.E' , sxc1 xaaR:»iRx Y••.`isaRk sa•xs 3kxs'ryY.p s:sl�''pas.3x es�s1:xs,.x.x R.C`a%s�Axia:a xex.ak.ea.as,.aax,s.xae.rcsYasp>.as..s xx ks a.Cs..s aSx,ms sa axa xasayx.x»� a a xxxx ao s�a�skk&1�xy i'`fiCk ¢xy: Address: �— Property Tax ID#: � C1 5�D ® c c9 Z}— � '� i Lot No. —z" Site Plan Name: ,-gleek No. Project Name: l � I u..x ra ..vF x H a e4 <ak '.. 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R 'a'a�F:k.. I&H �kxaeaxxxxxxaa R R Y k.nxY lx'"s 4 l fix.» 3 �sxxx� Fxx >•aaa,ss s xxxxs xaxaxv.xxxxssR xa xxaxa ;a xsxe.xsxxx�a s .xks. xlsa s.eFasl sx _....�. ... .... _ :., .... ....... .,k as. R, s; e s s >ea x e�.x xss e, s .xx k k,ax.....aR.....R : .Ra...R.. ..�§ a.. Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors Pond I V Electric Plumbing Sprinklers Generator Roof CZ—•Pitch. Total Sq. Ft of Construction: 1%, I Sq. Ft.of First Floor: f Cost of Construction: $ - ©(�>v .--. Utilities: _Sewer _Septic Building Height: �L7 »akxYa..k C 'vi k' i ei>'•vk k 3vx.. ea.a i ke aaeS xa k Y R R- 4'"Ck k e'xk 'i 'xyYk.uSyxkaxeu( R.: � .... � ��`'. C 4Yv�' � xxrRi �' �� RZ a vi. ! 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T ����� � � � � �� ��,��5€�k» x5 xx ..x> x, xxx3.:�x» e.a� �.7xax�x.x R T� �.'�'2, .� 1. exxR�$xxxxxxxi xi xasxxa''� axk s�x sx srskC � ass �& s svxxxaax.>`a,� Z a»aa:,a R,x xxx : � k' k ea a t x .awvxxxsxaxxssax xx>..axxx %... .... • ..,aaRx a•I .,xxy� avk xxa .. xaa�xaxxxaxxaxxaxa,..... vk. `:�y.>xvavi x�:e ..,a..si�.:R �>x aax�an, .,va.,'-a R ... ... >z•exex :. vpaarq axx Name Name: - Address: Company: City: Address: (7a4LZ —C� Zip Code-. >94q%5:7 Fax: City: � I State: ];P _ i Phone No. E- Zip Code:? �q0 Fax: Mail: Phone No Fill in fee simple Title Holder on next page (if different E-Mail Sr% 2S=A -Le from the Owner listed above) State or County Licensee (f'C_V-Z7 zt"o .SS 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. I i I i � ,%.:,<.x Nye Ell r �»� �... � „..�,,u....,,.ua�s� .�H�., mom �., ,F � (�� .[� a>. >. .,. g� a,. .,. t^,:: : � _: e ., �.ak.�. .. � . . ,gay �:. i a. ��.�"ku .s...>.�:�� �.t�e��a�l,?� ?���..>�.: �.;�. ,.�� >�x���;����.r»:�� a.> � �. , � ,��,a�, .�, �� 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 perrrit 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 i1ses 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 Contractor-or-Owner Buildet as applicable STATE OF FLORIDA�� COUNTY OF �� Swor to(or affirmed and subscribed befne'of P� hysical Presence or Online Notarization this day of 20 Name of person making statement. Personally Known OR Produced Identification Type of Identifica ion Produced P161 (Signature of Noiary Public-State f Florida) Commission No. (Seal) ;oAWN,o,, HEATHER BURFORD �r Notary Public-State of Florida < Commission#HH 218'910 � �� :•` My Commission Expires Ffibruary 06,2028� . REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev 10/12/21