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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED' Date: �� 20 2 Z, Permit Number: aad3'a`i`I 1 RECEIVED R_Mts:- O 152022 Permit Appa Planning and Development Services St, Lucie County/ Building and Code Regulation Division Commercial Residentlff Filtil r 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding PERMIT APPLICATION FOR: 614N , Address: 2 2 O Property Tax ID #: 3 Site Plan Name: IC 1 V Project Name: L E �15 i N tZni2 �l e! c• 1J�� �. Luck'a 5 OI - OO 3 6 L\ T`I©NOf VIlORK: M Lot No. 3 Block No. 1+ X� ��� l r` I H (% I�(�2t1 L 4 vie= �GC� �- �r ��-/�t� A%'; New Electrical Meter Second Electrical Meter (Affidavit required) Additional work to be performed under this permit— check all that apply: 'h' _Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond Electric _ Plumbing _ Sprinklers _ Generator _ Roof -a, Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floo�: D Cost of Construction: $� C`DO - Utilities: —Sewer _ Septic Buiilding Height: /LE-MSEE: Name C crQCli=LZ ��.�. cn Ca TR CTO Name: nvy► :1 Com an Addressy - 'I ` `� City:` Address: 2.20 E Q sz F-t''l6. Q Q v a. `: (� 1 r City: PrR hJLd` State: Fax: Code: Zi �'� 95 p p Phone No. 7-7 Z ( 0 6 8 Lf E- State: Fax: Zip Code: Phone No E-Mail State or County License Mail: G�1 c (_20 He (( MC, Cott) Fill in fee simp a Title Holder on next page (if different from the Owner listed above) 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. SllPl'LEMENTAL CO STRUCTION LIEN LAW INFORMATIQN° DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable Name: BONDING COMPANY: Not Applicable 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 Atorney before commencing work or recording our Notice of Commencement. Sign atur o Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF 'S Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization this \5 day of V\C'\ 20'4 ' by Name of person making statement. '.personally Known OR Produced Identification Type of Identification Produced YfX_ c (Signature of Notaryblic- State of Florid DEANNA GIVENS Commission No. al4otaryPubflc-State of Florida # HH 086359 Commission off` M Comm. Expires Jan 28, 2025 Y oFF;;• Bonded through National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5/20/21