HomeMy WebLinkAboutBuilding Permit Application. '7
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5 / ILI h-a Permit Number:
L T "�` Building Permit Application
Planning and Development Services
Building and Code Regulation. Division Commercial Residential: V
2300 Virginia Avenue, Fort Pierce.FL 34982
Phone: (772) 462-1553Fax: (772) 462-1578 . CBDG Funding
PERM IT. APPLICATION FOR: i
PROPOSEWMPROVEMENTELOCATION.;.
Address:
Property Tax ID #: . 3 0 L i6 oG - nn b ro - aoc) - :% Lot No.
Site Plan Name: Block No,
Project Name:
DETAILED 'DESCRIPTION, OF W. ,,ORK:
i ar./ r nn � , _II. ,
New Electrical Meter Second Electrical Meter (Affidavit required)
CONS,TRU,CTI:ON INFORMATION*, - -
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: $ i ��� o cin Utilities: —sewer —septic: Building Height: .
01NN ER4/LESSEE::::
! CO-NF jRA. �-., ,OR;.' _
Name 5i ! �{ r ' e I l,a l�. #.xa .,(. r off.: , _ „ ;) ;
Name: 5� L u—oa lay 6)oJ Z6 r AL.O, .6
Address: 70 9 s; f� �
Company:
City: 1'no•� I�`2r�e Stater
Address: W 0
Zip Code: �4 91S"a Fax:
City: F14 k State: III —
Phone No, 77i- 46 y-/I! y E-
Zip Code: 3`lQc, Fax:
Mail:y a I .� ���� (NSF /�C� e�n�D, j,. . �r'cr
Phone No 7 71 U -!I!7
Fill in fee simple Title Holder on next page:(if.different
6-Mail
from the Owner listed above)
State or County License
IIf value of construction is 2500 or more; a KtLUKutu:rvotice or t.ommenL;emena IZOI CLIUIl r - I
If value -of HAVC is $7,500 or -more, a RECORDED Notice of Commencementis required:.
S,UPP.I:EMENTAL CONSTRUCTION'UENI:CAW_;
INFORMATION,
DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY:
-No t Applicable
.Name:
Name:: . •
Address:
Address:
City:.
Stater
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 he'reby made.to obtain `a permit to do.the work and installation as indicated.
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 do4fereby 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 o:fCommencement 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-attorneybefore commencingwork or recordingour Notice of Commencement.
ev-
Signat re of Contractor - or -Owner Builder as applicable
STATE OF FLORIDA.
COUNTY OF l'z1q ;
.
Sworn, �Q•.(or affr d) and subscribed befo a me of �
Physical Presence or Online Notarization
this day of 20� by '
Name of person making statement.
Personally Known OR Produced Identification
T of Identificatio Pro d
L_ o . ���..' � ate•- r 4 N:---- _
`
(Signatur-e:of Not Public- State of Florida)
.
No. 67 05) (Seal) ?° ••"' .� :
DONNALIeA A8KAVW
'
Commission .
Commis><Icn # HH 2O8261
ExQket January 9.2026 .
soF r`°1��°�
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