HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABEE 1NFO-MUST gr: cOMPLE W FOR APPLICATION TO BEAM-:. .- :� D
Date:
Planning ond'DevelopmentServices
Permit Number.. aOj - 0y N
RECEIVED
JA N 19 2022
Building. Permit Application �t. Lucie County
Permitting
Building and Code Regulation DlvWon
2300 Virginia Avenue, Fort Plerce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Address:
Commercial Residential
PropertyTax ID #: /y/ -r 741/- O Lot No.�_
Site Plan Name: �o ,�c -�. s� Bock No.
Project Name:
[ DETAILI D.DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter I
I CONSTRUCLIOIN INFORMATION:
Additional work to be perParmed 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: f
Cost of Construction:
Sq_ Ft of FrstTloor.
Utilities. _Sewer _Septic Building Height
Address: 70'
City: •State:
Zip Code: y Fax:
Phone No. 706,
E Mail:
Fill in fee simple Title Holder on next page ( N different
from the Owner listed above)
City: PeZ� State
Zip Code: &�= Fax:
Phone No(.ZM2 s?-457'27
E-Mail^
State or County License CAW
if value of construction is 2500 or more, &RECORDED 1lbtice of commencement is required.
If value of HAVC is $7,500'or more, a RECORDED Notice of Commencement is required.
ZUVFLtj1V!FNTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGName ERjFNGINEE�R�: Not A pticabte MORTGAGE. COMPANY: Not A Name alLi�t�� a .,mac rGT Applicable
Add r ss.1 Name:
City: # o� Address:
ZIP: 132G Phone y State: G City: State:
{ --; /��� Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:1
City. C Address:
Zip: t Phone: Ot''
J Zip: Phone:
OWNER/ COl14TRAG'rOR'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 Counttyy makes no representation that granting a permit will authorize the ermit holder to build the subject structure
whicht is e. Please
with with applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners 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 Elorida 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, wails,,signs, screen rooms and' accessory uses to another non-resldential 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 oil the jobsite before the first inspection. If you intend to obtain financing, consult
with Jender or au,attornev bef0ra cnmmnnr�.n ......6
�4ont'�el�as Agent for Owner Sigrtat of Contra n
STATE OF FILO DA STATE OF FLORi
COUNTY OF / i c COUNTY OF �`� Q
S to (or affirmed) and subscribed before me of S n to 'or affirmed and subscribed
seal Pres nce or Onrne Notarization { J su scribed before me of
this day of P^�'sical. Press ce or online No�rization
i 2 by this _li_ day of Z� by
i
Name of pers nn5aki ement Name of perso making ^ e ent.
Personally KnownOR Produced Identification Personall Known ��
Type of ldentificetion Yj . �� OR Produced Identification
used i Type of Identification
Produced
(Signature of �otary Public -Stan g turd of Nota P
Notary Public State of FJ nd ry ublic-Stat ash
Commission No , Qunnie Merritt Woodard �WY P Notary Public State of Flo
Ii�a y Commission HH 039 2�am fission No. � ie Merritt Woodard
F Q` n Expires 09/07/2024
. .s M�yc commission HH 0398
off r` " Expires 09/07/2024
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