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HomeMy WebLinkAboutBuilding Permit Applicationr All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED. Date: �d��Cc�a� Permit Number:�b'd�'S E. Cn IJo RECEIVED r Building Permit Application OCT 2 6 2021 Planning and Development Services Lucla County Commercial Residents l'r-OrM1111% Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: ___� � P�-S•� �G`'� (�i72f 4-0" ' Address: ��.� � � 55-­- U,5 ff� 1� Property Tax ID #: - Lot No. Site Plan Name: Block No. Project Name: Of NEW K` ti'C1*,c7� C, PLI�-wlf�jfN�� 7 i=Lc C�l�rG.�L t�ol�lGS ONCH �A- C C,�521Z •� c �o �G /9-� ~ S New Electrical Meter Second Electrical Meter (Affidavit required) ',] rgogpag HE.,.p .. Additional work to be performed under this permit -check all that apply: _Mechanical _ Gas Tank —,Gas Piping _ Shutters —Windows/Doors _ Pond Electric P"Plumbing _ Sprinklers _ Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 16 ©Od Utilities: Sewer _ Septic Building Height: -.� - n,_ z kM _gig. Name C �i j Y of � T � � Address: ,6FD 4/ U f /�`U So Corn pa'n.y:.%tr2.r/�- (._(, r; city:�Ge,c, / �l,� a,� � � �C State: � Address: City: 'es " A 9� ,(c-Cc � State: F Zip Code: 3 4 ''It Z Fax: Phone No. %77 341 �' 3 S/( Zip Code: ?l. Lf Fax: E-Mail: Vgptcd7r1O 6r, 7-A(4yG • (-DM Phone No 7%2-- Zz�-( �� 1,L 0 Fill in fee simple Title Holder on next page ( if different E-Mail _ State or County License from the Owner listed above) �FG /4L vZ6� 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. AOL r law DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLEI'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 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 is in conflict with any 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 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 wi lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner/ L ssee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF LycVe- Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization thisa(� day of 20c.N by Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced 3:L b L �NA�►� 04Florida (Signature of Not y PuFy�i ate Public • qt% 086354 Commission No. Hdgw.?f jan 26.2025 lres mh National NotaryAssn, u% REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5 2 2